脉搏轮廓心输出量监测下重症胰腺炎补液的临床效果评价  

作　　者：符兆胤[1] 黄克刚[1] 陈帅[1] 李峥[1] 

机构地区：[1]广西钦州市第一人民医院重症医学科,535000

出　　处：《浙江临床医学》2016年第1期53-55,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨脉搏轮廓心输出量监测下重症胰腺炎补液的临床效果评价。方法选取2013年1月至2015年1月重症胰腺炎患者80例，根据患者及其家属是否同意行PICCO监测分为两组，观察组48例行PICCO监测下输液，对照组32例留置中心静脉导管导管输液。观察两组患者输入液体量、动脉血压（MAP）、中心静脉压（CVP）、SevO2、PaO2／FiO2、全心舒张末期容积（GEDV）、血管外肺水（EVLW）、全心舒张末期容积（GEDV）、每搏量变异（Sw）等指标变化情况。结果经过6h补液后，两组患者MAP、CVP、ScvO2等比较，差异无统计学意义（P〉0．05），观察组患者输入液体量少于对照组，观察组PaO2／FiO2大于对照组，差异均有统计学意义（P〈0．05）；观察组患者入院时、治疗后24h、7d的GEDV和EVLW比较差异无统计学意义（P〉0．05）；治疗后7d的ITBV和SVV比入院时、治疗后24h降低，差异均有统计学意义（P〈0．05）；观察组血管活性药物使用时间、入住ICU天数、机械通气时间、28d病死率等均明显低于对照组，差异均有统计学意义（P〈0．05）。结论脉搏轮廓心输出量监测下重症胰腺炎补液可以减少补液量，降低肺水肿发生率，减少ICU入住时间，降低病死率。Objective To study the clinical effect of the pulse contour output monitoring under the guidance of the monitoring of the cardiac output of severe acute. Methods A total of 80 cases of patients with severe acute pancreatitis （ SAP ） in January 2013 to 2015 years January in our hospital inpatient treatment, according to the patients and their families agree, PiCCO monitoring is divided into the observation group and the control group, the observation group was treated with PiCCO monitoring, a total of 48 cases, control group indwelling central venous, a total of 32 cases. Observe two groups of patients with input quantity of liquid, arterial blood pressure （ map ） , central venous pressure （ CVP ） , ScvO2, PaOJ FiO2, heart end diastolic volume （ GEDV ） , end diastolic volume （ GEDV ） , vascular lung water EVLW, heart diastole, stroke volume variation （ SVV ） indicators of changes. Results After 6h after rehydration, compared two groups of patients with MAP, CVP, ScvO2, the difference was not statistically significant （P〉0.05） , patients in the observation group received liquid volume less than the control group, PaO2/FiO2 in the observation group than the control group, the differences were statistically significant （ V〈0.05 ） ; the observation group patients after treatment, 24h, 7d, GEDV and EVLW have little difference, the difference was not statistically significant （ P〉0.05 ） ; after the treatment of 7d ITBV and SVV 24h after treatment, the admission ratio decreased, the differences were statistically significant （ P〈0.05 ） ; the observation group use of vasoactive drugs, time duration of ICU, Mechanical ventilation time, the 28 day mortality rate were significantly lower than the control group, the differences were statistically significant （ P〈0.05 ） . Conclusion Pulse contour cardiac output monitoring in severe acute pancreatitis rehydration can reduce the amount of fluid infusion liquid, reduce the incidence of pulmonary edema and reduce the time of I

关 键 词：脉搏轮廓心输出量 重症胰腺炎 补液 临床效果 

分 类 号：R657.51[医药卫生—外科学]