肺移植术后行经肺温度稀释法监测及护理  

Monitoring and Nursing Care in Post-operated Lung Transplantation with PiCCO

作　　者：孔少烽[1] 侯春怡[1] 宫玉翠[1] 

机构地区：[1]广州医学院第一附属医院广州呼吸疾病研究所重症医学科,510120

出　　处：《中华全科医学》2012年第1期148-149,共2页Chinese Journal of General Practice

摘　　要：目的探讨经肺温度稀释法监测(PiCCO)技术对肺移植术后的监测及护理。方法回顾分析2005～2010年广州医学院第一附属医院重症医学科收治的31例肺移植术后患者进行PiCCO监测的护理和方法。所有患者均经右颈内静脉留置中心静脉导管和经肱动脉留置PiCCO导管。每天进行3次以上的经肺温度稀释测量,根据测量结果(心输出量、血管外肺水、胸腔内血容量等)进行液体管理,控制补液速度和出入量情况。结果 31例患者均病情稳定后转出ICU,平均置管时间2～5 d,患者在使用PiCCO监测期间均未出现管道堵塞、血管栓塞、低氧血症、呼吸困难、肺水肿等并发症。结论肺移植术后患者使用PiCCO进行血流动力学监测,对于液体管理起到重要作用。Objective To investigate the effect of monitoring and nursing care in post-operated lung transplantation with PiCCO.Methods 31 lung-transplant patients were treated with monitoring and nursing care with PiCCO between 2005 and 2010.All of the patients had central venous catheter in right jugular vein and PiCCO catheter in brachial artery.Transpulmonary thermodilution measurement was done at least 3 times a day for each patient.Fluid management was guided by the result of transpulmonary thermodilution（cardiac output,extravascular lung water,intrathoracic blood volume,ect）.Results All of the patients were recovered and transfered out of ICU,mean days of catheter placing were 2-5 days.There were no complications of clotting,embolism,hypoxemia or pulmonary edema.Conclusion Monitoring with PiCCO in post-operated lung transplantation was good for fluid management.

关 键 词：肺移植 PICCO监测 护理 重症监护 

分 类 号：R473.52[医药卫生—护理学] R655.3[医药卫生—临床医学]