PiCCO在高频通气治疗儿童急性呼吸窘迫综合征中的应用

发布时间：2018-05-27 03:08

本文选题：呼吸窘迫综合征 + 儿童　；参考：《重庆医学》2017年19期

【摘要】：目的探讨脉搏指示轮廓连续心排血量技术(PiCCO)在指导高频通气治疗儿童急性呼吸窘迫综合征(ARDS)液体容量管理治疗及判断预后的意义,为ARDS患儿的治疗提供新的参考。方法选取2013年1月至2015年8月入住该院儿科重症监护病房(PICU)的确诊ARDS患儿56例,将其按入院住院号奇偶数分为观察组与对照组,两组患儿均给予常规监护及治疗,观察组在此基础上应用PiCCO对血流动力学的变化进行监测,并根据结果进行早期积极的液体容量管理,对照组给予经验性液体治疗管理。比较两组患儿的血流动力学指标、氧合指数(OI)及预后。结果与对照组比较,观察组危重症评分在治疗24、72h时均明显升高,OI均明显下降,差异均有统计学意义(P0.05);观察组机械通气时间和PICU入住时间明显较对照组短,差异均有统计学意义(P0.05)。观察组存活患儿与死亡患儿血管外肺水指数(EVLWI)比较,差异无统计学意义(P0.05)。结论应用PiCCO指导高频通气儿童ARDS早期液体治疗能有效缩短患儿机械通气时间和PICU入住时间,对改善预后无明显影响。
[Abstract]:Objective to explore the clinical significance of continuous cardiac output with pulse indicating profile in guiding high frequency ventilation in the treatment of children with acute respiratory distress syndrome (ARDS) and its prognosis, and to provide a new reference for the treatment of children with acute respiratory distress syndrome (ARDS). Methods from January 2013 to August 2015, 56 children with ARDS admitted to pediatric intensive care unit (PICU) were divided into observation group and control group according to the number of hospital admission. The two groups were given routine care and treatment. On this basis, PiCCO was used to monitor hemodynamic changes in the observation group, and early and active liquid volume management was carried out according to the results, while the control group was administered with empirical fluid therapy. Hemodynamic indexes, oxygenation index (OI) and prognosis were compared between the two groups. Results compared with the control group, the scores of critical disease in the observation group were significantly higher than those in the control group at 2472h, and the difference was statistically significant (P 0.05), and the time of mechanical ventilation and PICU stay in the observation group was significantly shorter than that in the control group (P 0.05). There was no significant difference in extravascular pulmonary water index (EVLWI) between surviving and dead children in the observation group (P 0.05). Conclusion early liquid therapy of ARDS in children with high frequency ventilation guided by PiCCO can effectively shorten the time of mechanical ventilation and stay of PICU, and has no effect on the prognosis.
【作者单位】：郑州儿童医院PICU;
【基金】：河南省卫生科技攻关项目(201303233)
【分类号】：R720.597

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