脉搏指示连续心排血量联合中心静脉压监测对机械通气老年危重患者的临床价值  

CLINICAL VALUE OF PICCO COMBINED WITH CVP MONITORING IN CRITICALLY ILL PATIENTS WITH MECHANICAL VENTILATION

作　　者：白国欣[1] 王伟[1] 曹振敏[1] 张培花[1] 姜雪莲[1] 

机构地区：[1]河北省沧州市中心医院,061001

出　　处：《中国煤炭工业医学杂志》2017年第6期673-677,共5页Chinese Journal of Coal Industry Medicine

基　　金：2016年度沧州市科技计划项目(编号:162302004)

摘　　要：目的探讨脉搏指示连续心排血量(PICCO)监测在机械通气治疗老年危重患者中的临床应用价值。方法患者资料来源于2015年1月—2016年12月就诊于该院重症医学科及神经外科监护室内机械通气治疗的76例患者,采用回顾性方法进行研究,将其分为对照组(36例)与观察组(40例),观察并记录二种监测方法对患者临床治疗的指导意义。结果观察组患者在治疗24h及治疗48h后的心率(HR)、平均动脉压(MAP)、血乳酸(LAC)、尿量及碳酸氢根均与对照组患者差异有统计学意义(P<0.05),观察组患者机械通气时间、住院时间及死亡人数均显著少于对照组,且差异具有统计学意义(P<0.05),二组患者活化部分凝血酶原时间(APTT)及血浆凝血酶原时间(PT)之间差异无统计学意义(P>0.05)。结论中心静脉压(CVP)监测对机械通气老年患者临床治疗具有较为显著的指导意义,联合应用PICCO,其指导价值更为突出,值得广泛开展于临床中。Objective To explore the clinical value of PICCO （pulse indicates continuous cardiac output） in monitoring elderly patients with severe mechanical ventilation.Methods A retrospective study on 76 patients＇ data with mechanical ventilation from January 2015 to December 2016 in intensive care and neurosurgical care room in author＇ s hospital, and they were divided into control group （n = 36） and observation group （n = 40）. The significance of the two monitoring methods for clinical treatment was observed and recorded.Results HR （heart rate）, MAP （ mean arterial pressure）, LAC （ blood lactate）, urine output and bicarbonate were signifi- cantly different between the two groups （P 〈0.05 ）. The time of mechanical ventilation and hospital stay, death toll in the observation group were significantly lower than those in the control group （P 〈0.05）, but the APTT （activated partial prothrombin time） and PT （plasma thrombin） were not difference between the two groups （P〉0.05）. Conclusion CVP （central venous pressure） monitoring has a significant significance in clinical treatment of elderly patients with mechanical ventilation, and its guiding value is more prominent combined with using of PICCO,worthy of extensive clinical practice.

关 键 词：脉搏指示连续心排血量 中心静脉压 机械通气 监测 

分 类 号：R749.16[医药卫生—神经病学与精神病学]