PICCO技术在严重脓毒症输液管理中的应用与护理  

作　　者：郑玉玲[1] 黄庆萍[1] 杨凤玲[1] 邹丹[1] 张惠敏[1] 

机构地区：[1]东莞市厚街医院重症医学科,523945

出　　处：《当代医学》2011年第7期12-14,共3页Contemporary Medicine

摘　　要：目的探讨PICCO监测技术对严重脓毒症患者输液管理与护理。方法通过PICCO(pulseindicatedconitinuouscardiacoutput)技术(PULSION公司,德国),即经肺热稀释方法和脉搏轮廓分析法,对28例因严重脓毒症入住ICU的患者,监测MAP、CI、SI、SV、EVLWI、ITBVI、GEDVI,记录液体复苏前后的上述指标。结果复苏前与复苏终点(感染发生后6～10小时内)相比,ITBVI、GEDVI与SI有显著相关性,P<0.01;HR与SI似呈负相关,P>0.05;CVP、MAP与SI相关性较差,P>0.05;复苏后的胸腔内血容量变化(ΔITBVI)与每搏输出量指数变化(ΔSI)有显著相关性,P<0.01;全心舒张末期总容量指数变化(ΔGEDVI)与ΔSI显著正相关,P<0.05;而ΔCVP、ΔHR、ΔMAP与ΔSI相关性较差P>0.05。结论 ITBVI、GEDVI及容量复苏后的变化可以准确、可靠地评估患者容量状况,指导严重脓毒症患者的液体治疗。Objective Explore PICCO monitoring technology for severe sepsis infusion administration and nursing.Methods By PICCO（pulse2indicated conitinuous cardiac output） technology（PULSION company,Germany） by the lung thermodilution method and pulse contour analysis,28 cases of severe sepsis in ICU patients,monitoring MAP,CI,SI,SV,EVLW I,ITBV I,GEDV I,records resuscitation of the above indicators before and after.Results Before the end of the recovery and recovery（infection occurred after 6 ~ 10 hours）,compared to ITBV I、GEDV I and a significant.correlation between SI,P0.01;HR and SI like negative correlation,P0.05;CVP,MAP and correlation between poor SI 0.05,P;resuscitation of intrathoracic blood volume changes（ΔITBVI） and stroke output index changes（Δ S I） significant correlation,P0.01;full-xin diastolic total capacity index（ΔGEDV I） and Δ S I,marked positive,P0.05;ΔCVP,ΔHR,ΔMAPand ΔSI correlation between poor P0.05.Conclusion ITBV I,GEDV I and capacity changes after the recovery can be accurate and reliable assessment of the situation,the guidance capacity in patients with severe sepsis treatment of liquid.

关 键 词：胸腔内血容量指数 全心舒张末期容量指数 严重脓毒症 血流动力学 输液管理 

分 类 号：R473.5[医药卫生—护理学]