脉搏指示连续心排出量在胸部创伤患者液体复苏中应用的临床研究

发布时间：2018-07-15 13:30

【摘要】：目的探讨脉搏指示连续心排出量(PICCO)在胸部创伤患者液体复苏中的应用效果。方法 2013年10月—2016年12月在本院就诊的由于胸部创伤导致失血性休克的患者共86例,根据监测方法分为常规组41例和PICCO组45例。常规组采用早期目标导向治疗(EGDT)方案进行液体复苏,PICCO组在PICCO监测技术下进行复苏。对比两组患者治疗前和复苏后6 h的心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、中心静血氧饱和度(ScvO_2)、血乳酸值、剩余碱值,对比两组患者的ICU留置时间、机械通气时间、液体复苏时间及达到早期复苏目标时间,对比两组患者血管活性药物使用量。结果复苏后6 h两组的HR、MAP、ScvO_2比较,差异无统计学意义(P0.05);复苏后6 h PICCO组的CVP高于常规组(P0.05),血乳酸和剩余碱低于常规组(P0.05)。PICCO组患者的ICU留置时间、机械通气时间、液体复苏时间、达到早期复苏目标时间短于常规组,血管活性药物使用量低于常规组,差异有统计学意义(P0.01)。结论 PICCO在胸部创伤患者指导液体复苏、改善复苏效果、对血管活性药物的应用中具有良好的指导作用。
[Abstract]:Objective to investigate the effect of pulse indication continuous cardiac output (PICCO) on fluid resuscitation in patients with thoracic trauma. Methods 86 patients with hemorrhagic shock caused by chest trauma in our hospital from October 2013 to December 2016 were divided into 41 cases in routine group and 45 cases in group PICCO according to the monitoring methods. The treatment (EGDT) scheme was carried out with fluid resuscitation and the group PICCO was resuscitated under the PICCO monitoring technique. The heart rate (HR) before and after the recovery of the two groups, the mean arterial pressure (MAP), the central venous pressure (CVP), the central static oxygen saturation (ScvO_2), the blood lactic acid value and the residual base value were compared, and the ICU retention time of the two groups, the time of mechanical ventilation, and the liquid were compared. The volume of vasoactive drugs used in the two groups was compared with the time of early recovery and the time of early recovery. The results showed that there was no significant difference in the HR, MAP, ScvO_2 of the two groups after the recovery (P0.05), and the CVP in the 6 h PICCO group after resuscitation was higher than that of the conventional group (P0.05), and the blood lactic acid and residual alkali were lower than those of the conventional group (P0.05).PICCO group. The time of mechanical ventilation and the time of fluid resuscitation were shorter than those of the conventional group, and the use of vasoactive drugs was lower than that of the conventional group. The difference was statistically significant (P0.01). Conclusion PICCO has a good guiding role in guiding the resuscitation of fluid and improving the effect of resuscitation in the patients with thoracic trauma.
【作者单位】：浙江省衢州市中医院;
【分类号】：R655

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