脉搏指示连续心排技术用于机械通气患者液体平衡的监测  

Application of PiCCO technique in management and nursing of the fluid balance of mechanically ventilated patients

作　　者：胡长玉[1] 

机构地区：[1]桂林医学院附属医院重症科,541001

出　　处：《中国实用护理杂志》2011年第21期12-14,共3页Chinese Journal of Practical Nursing

摘　　要：目的确定脉搏指示连续心排（pulse indicator continuous cardiac output，PiCCO）技术在监测及评价机械通气患者液体输入方面的价值。方法对18例机械通气患者安装PiCCO导管并对其主要数据做前瞻性记录及统计学分析。同时，与相关CVP数据作对比分析。结果监测期间，全心舒张末期容量（GEDV）及胸腔内血容量（ITBV）均大于正常值，且在监测期间无显著性变化。血管外肺水指数（EVLWI）亦明显高于正常值，但在监测期间渐下降，但此下降无显著性。心排血指数（CI）在正常值范围且无大的变化。GEDV，ITBV与EVLWI及CI均明显相关，而CVP与EVLWI及CI均无任何相关性。结论源于PiCCO技术的容量指标（GEDV，ITBV）在判定及指导液体输入方面较压力指标（CVP）可提供更有意义的判定标准。Objective To evaluate whether PiCCO（pulse indicator continuous cardiac output） technique using for monitoring and guiding fluid infusion is a valuable tool in patients with mechanical ventilation. Methods Eighteen consecutive mechanically ventilated patients were installed PiCCO catheter and CVP catheter. All data from PiCCO technique were recorded and analyzed prospectively. Meanwhile, all data from PiCCO technique were compared with data from CVP. Results During the period of five-day monitoring, GEDV and 1TBV were always higher than normal value and remained unchanged significantly. EVLWI was also higher significantly than normal value but decreased not significantly during the period of five-day monitoring. CI was normal and remained unchanged basically. GEDV and ITBV were significantly correlated with EVLWI and CI, but not CVP. Conclusions Volume variables（GEDV,ITBV） from PiCCO technique are more useful indicators than pressure variables （CVP）for assessment and guidance of fluid infusion.

关 键 词：血流动力学 血管外肺水指数 输液 胸腔内血容量 全心舒张末期容量 

分 类 号：R459.7[医药卫生—急诊医学]