PiCCO监测技术在感染性休克患者液体复苏及血管活性药物应用中的指导作用  

Value of PiCCO monitoring technique in guiding use of fluid resuscitation and vasoactive drugs for patients with septic shock

作　　者：刘亚林[1] 邹帅[1] 赵中林[1] 王晓睿[1] 张婷[1] 陈钇然 

机构地区：[1]重庆市第五人民医院重症医学科,重庆400062

出　　处：《中华医院感染学杂志》2016年第10期2254-2256,共3页Chinese Journal of Nosocomiology

基　　金：重庆市医药卫生科研基金资助项目(2012-2-508)

摘　　要：目的针对脉搏指示连续心输出量测定(PiCCO)监测技术在感染性休克患者液体复苏及血管活性药物应用中的指导作用进行研究,为患者病情观察治疗方案制定的监测方法的选择提供依据。方法选择2012年12月-2015年9月医院收治的感染性休克患者120例,随机分为对照组和观察组,各60例;对照组患者实施EGDT方案指导液体复苏,观察组患者采用PiCCO监测技术指导液体复苏;对两组患者的复苏、血管活性药物的使用、治疗效果等进行对比分析;采用SPSS16.5软件对数据进行统计分析。结果观察组患者的血管活性药物的应用与对照组比较,差异有统计学意义(P<0.05);观察组患者的APACHEⅡ评分与对照组患者比较,差异有统计学意义(P<0.05);观察组患者的PaO2/FiO2与对照组比较,差异有统计学意义(P<0.05);观察组患者的复苏成功率为83.33%,对照组的复苏成功率为66.67%,差异有统计学意义(P<0.05);观察组患者的ICU留置时间、机械通气时间、达到早期复苏目标(EGDT)时间、液体复苏时间与对照组比较,差异有统计学意义(P<0.05);观察组患者肺水肿发生率和病死率与对照组比较,差异均有统计学意义(P<0.05);观察组患者的乳酸水平、排尿量、ScvO2水平与对照组比较,差异有统计学意义(P<0.05)。结论感染性休克患者在PiCCO监测技术下,液体复苏效果较好,对患者的血管活性药物的使用有积极的指导作用,值得在临床上进行推广。OBJECTIVE To observe the value of pulse indicates continuous cardiac output（PiCCO）monitoring technique in guiding the use of fluid resuscitation and vasoactive drugs for patients with septic shock so as to provide guidance for monitoring of illness condition of the patients.METHODS A total of 120 patients with septic shock who were treated in the hospital from Dec 2012 to Sep 2015 were enrolled in the study and randomly divided into the control group and the observation group,with 60 cases in each.The control group was treated with EGDT to guide the fluid resuscitation,while the observation group was given the PiCCO monitoring technique to guide the fluid resuscitation.The usage of resuscitation and vasoactive drugs and therapeutic effects were observed and compared between the two groups of patients,and the statistical analysis of data was performed with the use of SPSS16.5software.RESULTS There was significant difference in the usage of vasoactive drugs between the observation group and the control group（P〈0.05）.There was significant difference in the APACHE Ⅱscore between the observation group and the control group（P〈0.05）.There was significant difference in the PaO2/FiO2 between the observation group and the control group（P〈0.05）.The success rate of resuscitation was 83.33% in the observation group,66.67%in the control group,and there was significant difference（P〈0.05）.There was significant difference in the ICU stay,mechanical ventilation duration,time to reach early goal-directed therapy（EGDT）,or fluid resuscitation time between the observation group and the control group（P〈0.05）.There was significant difference in the incidence of pulmonary edema or mortality rate between the observation group and the control group（P〈0.05）.There was significant difference in the lactic acid level,urine output,or ScvO2 level between the observation group and the control group（P〈0.05）.CONCLUSION The PiCCO monitoring technique can help the patients with septic shock to achie

关 键 词：PiCCO监测技术 感染性休克 液体复苏 血管活性药物 

分 类 号：R459.7[医药卫生—急诊医学]