感染性休克复苏达标后脉搏指示连续心输出量指导下不同液体管理方式对预后的影响  

Effects of different fluid management modes guided by PiCCO on patients with septic shock afterearly goal -directed therapy

作　　者：孟东亮[1] 茅尧生[1] 应利君[2] 吕铁[2] 周蕾[2] 金烈洲[2] 

机构地区：[1]温州医学院第一临床学院,浙江温州325035 [2]绍兴市人民医院重症医学科,浙江绍兴312000

出　　处：《中国急救医学》2013年第2期107-110,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探究感染性休克患者早期目标指导治疗（EGDT）达标后，在脉搏指示连续心输出量（HCCO）指导下采取不同液体管理方式与预后的关系。方法选择2010一01—2011—12入住我院ICU，确诊感染性休克且6h内EGDT达标的患者62例，随机分为液体限制组和液体非限制组，在PiCCO监测下执行液体管理，并采集病例相关数据。观察28d，比较不同组间患者机械通气时间、住ICU时间、病死率及多器官功能障碍综合征（MODS）发生率等。结果液体限制组与液体非限制组28d病死率和MODS发生率比较差异无统计学意义（P〉0．05），但两组使用呼吸机时间、住ICU时间比较差异有统计学意义（P〈0．05）。结论感染性休克患者早期液体复苏达标后，在HCCO指导下实施限制性补液可以尽早脱机，缩短住ICU时间。Objective To investigate the relationship between the different modes of fluid management guided by PiCCO and the prognosis in the patients with septic shock. Methods 62 patients with septic shock admitted to the Department of critical care medicine of Shaoxing People ＂s Hospital from 2010 -01 to 2011 - 12 and met EGDT standards within 6 hours were studied. All patients were randomly divided into two groups （limited fluid input and unlimited fluid input）, given fluid management by PiCCO monitoring, and to compare some data including the days of using mechanical ventilation, the days in ICU, mortality and muhiple organ dysfunction syndrome （MODS） incidence within 28 d. Results There were no differences in the mortality and the MODS incidence between two groups （P 〉 0.05）, but there were obvious differences in the days of using mechanical ventilation and the days in ICU（P 〈 0.05）. Conclusion It is reasonable choice to carry out limited fluid management guided by PiCCO to worn from respirator quickly and shorten the days in ICU for patients with septic shock after early goal -directed therapy.

关 键 词：感染性休克 液体管理 脉搏指示连续心输出量(PiCCO) 预后 

分 类 号：R631.4[医药卫生—外科学]