快速反应体系联合PiCCO监测对感染性休克患者液体复苏监控效果及抢救成功率影响研究

发布时间：2018-11-20 12:02

【摘要】：目的探讨快速反应系统联合脉搏指示持续心输出量(PiCCO)监测对感染性休克患者液体复苏监控效果及抢救成功率影响,为感染性休克患者的医院治疗管理模式以及液体复苏指导提供借鉴。方法选择快速反应系统运行后2016年1月-7月医院ICU病房收治的感染性休克患者67例作为试验组,再选择快速反应系统运行前2015年6月-12月收治的感染性休克患者59例作为对照组,对照组采取常规ICU管理模式以及常规液体复苏方案,试验组采取快速反应系统并采用PiCCO监测技术指导液体复苏,比较两组治疗效果、血管活性药物使用情况、复苏效果、抢救成功率等。结果治疗后两组患者MAP、血乳酸水平、尿量、血管活性药物评分以及APACHE II评分均较治疗前显著改善(P0.05),且试验组改善情况显著优于对照组(P0.05);试验组患者机械通气时间、入住ICU时间以及血管活性药物使用时间均显著低于对照组(P0.05);试验组患者复苏成功率显著高于对照组(P0.05),试验组患者肺水肿发生率以及病死率显著低于对照组(P0.05)。结论快速反应系统联合PiCCO监测对患者液体复苏的监控效果良好,能够有效提高患者的液体复苏成功率及抢救成功率,并有助于患者的康复,值得临床推广运用。
[Abstract]:Objective to investigate the effect of rapid response system combined with pulse indicator continuous cardiac output (PiCCO) monitoring on fluid resuscitation monitoring and rescue success rate in septic shock patients. To provide reference for hospital treatment management model and fluid resuscitation guidance for septic shock patients. Methods Sixty-seven patients with septic shock treated in ICU ward of hospital from January to July 2016 were selected as experimental group. 59 patients with septic shock admitted from June to December 2015 were selected as control group. The control group was treated with routine ICU management model and routine fluid resuscitation regimen. The experimental group adopted rapid reaction system and PiCCO monitoring technology to guide fluid resuscitation, and compared the therapeutic effect, the use of vasoactive drugs, the effect of resuscitation and the rescue success rate between the two groups. Results after treatment, the blood lactate level, urine volume, vasoactive drug score and APACHE II score of the two groups were significantly improved (P0.05), and the improvement of the test group was significantly better than that of the control group (P0.05). The time of mechanical ventilation, ICU stay and the use of vasoactive drugs in the test group were significantly lower than those in the control group (P0.05). The success rate of resuscitation in the trial group was significantly higher than that in the control group (P0.05), and the incidence and mortality of pulmonary edema in the trial group was significantly lower than that in the control group (P0.05). Conclusion the rapid response system combined with PiCCO monitoring is effective in monitoring fluid resuscitation, which can effectively improve the success rate of fluid resuscitation and rescue of patients, and is helpful to the rehabilitation of patients. It is worth popularizing in clinic.
【作者单位】：南华大学附属第一医院重症医学科;
【分类号】：R459.7

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