脉搏指示连续心输出量技术目标导向液体复苏治疗在烧伤早期中的应用研究

发布时间：2019-01-01 12:04

【摘要】：目的评估脉搏指示连续心输出量(Pi CCO)技术和传统补液公式方案在烧伤早期液体复苏的差异。方法选取2010年1月—2014年1月广西医科大学第一附属医院重症医学科符合纳入与排除标准的烧伤患者13例为研究对象。采用随机数字表法将患者分为研究组(7例)和对照组(6例)。研究组在Pi CCO技术目标导向下进行液体复苏,对照组依据传统补液公式,在传统生命体征监测、尿量、中心静脉压(CVP)的指导下进行液体复苏。记录患者一般资料、日均补液总量、日均尿量、日均心率、日均平均动脉压(MAP)、日均CVP、血管活性药物用量,第1~3天胸腔内血容量指数(ITBI)、心脏指数(CI)、CVP,第3天血肌酐水平、第3天血尿素氮水平、ICU住院时间、病死率。结果研究组患者日均补液总量、日均尿量高于对照组(P0.05);研究组患者日均心率、日均MAP、血管活性药物用量低于对照组(P0.05);两组患者日均CVP比较,差异无统计学意义(P0.05)。研究组患者第2天、第3天ITBI、CI高于第1天,第3天ITBI、CI高于第2天(P0.05)。研究组患者第1~3天CVP比较,差异无统计学意义(P0.05)。两组患者第3天血肌酐水平、第3天血尿素氮水平比较,差异无统计学意义(P0.05);研究组患者ICU住院时间短于对照组(P0.05)。研究组病死率为3/7,对照组为3/6,差异无统计学意义(P=1.000)。结论采用Pi CCO技术目标导向液体复苏治疗烧伤早期更有利于精准判断患者所需液体量,以尽早达到复苏目标。
[Abstract]:Objective to evaluate the difference between pulse indicator continuous cardiac output (Pi CCO) and conventional fluid resuscitation in early burn stage. Methods from January 2010 to January 2014, 13 burn patients who met the criteria of inclusion and exclusion in the Department of intensive Medicine of the first affiliated Hospital of Guangxi Medical University were selected as the study objects. Patients were randomly divided into study group (n = 7) and control group (n = 6). The study group performed fluid resuscitation under the guidance of Pi CCO technique, while the control group performed fluid resuscitation under the guidance of traditional vital signs monitoring, urine volume and central venous pressure (CVP) according to the traditional fluid resuscitation formula. The general data of patients, total daily fluid rehydration, daily average urine volume, daily mean heart rate, daily mean arterial pressure (MAP), daily CVP, vasoactive drug dosage, intrathoracic blood volume index (ITBI),) and cardiac index (CI), CVP,) were recorded. Serum creatinine level on day 3, blood urea nitrogen level on day 3, hospitalization time of ICU, mortality rate. Results the amount of daily fluid rehydration and urine volume in the study group were higher than those in the control group (P0.05), the mean daily heart rate and the daily MAP, vasoactive drug dosage in the study group were lower than those in the control group (P0.05). There was no significant difference in daily CVP between the two groups (P0.05). The ITBI,CI of the study group was higher on the second day, the third day than the first day, and the ITBI,CI on the third day was higher than that on the second day (P0.05). There was no significant difference in CVP between the patients in the study group on day 1 and day 3 (P0.05). There was no significant difference in serum creatinine level between the two groups on the 3rd day and the blood urea nitrogen level on the third day (P0.05); the hospitalization time of ICU in the study group was shorter than that in the control group (P0.05). The mortality was 3 / 7 in the study group and 3 / 6 in the control group. There was no significant difference (P < 1. 000). Conclusion it is more beneficial to use Pi CCO technology to guide fluid resuscitation in the early stage of burn treatment to accurately judge the required liquid volume in order to reach the goal of resuscitation as soon as possible.
【作者单位】：广西医科大学第一附属医院重症医学科;
【基金】：卫生部国家临床重点专科建设项目(2011-873)
【分类号】：R644

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