PiCCO技术指导成人先天性心脏病围术期治疗的随机对照试验  

Perioperative Treatment of Adult Congenital Heart Disease by PiCCO Technique:A Randomized Controlled Trial

作　　者：蒙延海[1] 张燕搏[1] 杨克明[2] 刘玲峰[1] 黄海波[1] 常硕[1] 史晨[1] 张荣媛[1] 杨秋蓝[1] 刘子娜[1] 

机构地区：[1]国家心血管病中心中国医学科学院阜外医院心血管疾病国家重点实验室,第二住院部心外科ICU,北京100037 [2]国家心血管病中心中国医学科学院阜外医院心血管疾病国家重点实验室,第二住院部心外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2016年第10期949-953,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金项目(81400305);北京市自然科学基金(7142137);中央级公益性科研院所基本科研业务费资助项目(2012F-14)

摘　　要：目的探讨脉搏指示连续心排血量(pulse indicator continuous cardiac output,PiCCO)技术在成人先天性心脏病(adult congenital heart disease,ACHD)围术期治疗中的应用价值及指导意义。方法选择2014年6月至2015年6月共100例ACHD行手术治疗的患者(男44例、女56例),随机分为PiCCO组和经验治疗(对照)组,每组各50例。PiCCO组根据放置PiCCO导管检测的相关数据进行血管活性药物及液体平衡管理,对照组根据常规监测数据对患者进行经验性处理,观察两组临床效果。结果 PiCCO组ACHD患者呼吸机时间、住ICU时间及住院时间明显短于对照组,差异有统计学意义(P值分别为0.02、0.03、0.04)。PiCCO组患者ICU期间血管活性药物(多巴胺、米力农)用量高于对照组(P<0.01,P=0.04)。术后两组住院期间均无死亡,术后并发症发生率差异无统计学意义(P>0.05)。结论 ACHD围术期应用PiCCO技术指导治疗并积极应用血管活性药物稳定循环可促进患者早期平稳恢复,具有一定的安全性和有效性。Objective To output （PiCCO） in perioperative evaluate the application value treatment of adult congenital and significance of pulse indicator continuous cardiac heart disease （ACHD）. Methods Between June 2014 and June 2015, 100 adult patients （44 females and 56 males） underwent congenital heart disease operation. Patients were randomly divided into a PiCCO group and an experience treatment （control） group. According to the data of PiCCO detection, the PiCCO group was treated with vasoactive drugs and liquid balance management, the control group was treated by routine monitoring data. The clinical effectiveness of the two groups was compared. Results The ventilator time, ICU time and length of stay in the PiCCO group were significantly shorter than those in the control group with statistical differences （P=0.02, 0.03, 0.04）. The drug dosage （dopamine, milrinone） during ICU were higher in the PiCCO group than those in the control group （P〈0.01, P=0.04）. There was no mortality in both groups. No significant difference was found in the incidence of postoperative complications between the two groups （P〉0.05）. Conclusions The application of PiCCO in the perioperative treatment of adult congenital heart disease can promote the early recovery of ACHD patients, and has a certain safety and effectiveness. Actively vasoactive drugs application to maintain circulation early in ICU has positive effect on the patient＇s recovery.

关 键 词：脉搏指示连续心排血量 成人先天性心脏病 随机对照试验 

分 类 号：R654.2[医药卫生—外科学]