慢性肺源性心脏病合并心源性休克应用PICCO监测仪的临床疗效及对患者血流动力学的影响  

Effect of PICCO Monitor and Its Effect on Hemodynamics in Patients with Chronic Pulmonary Heart Disease Complicated by Cardiogenic Shock

作　　者：魏华[1] 黄金秀 蔡海荣[1] WEI Hua;HUANG Jinxiu;CAI Hairong(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Chin)

机构地区：[1]广东省佛山市中医院,广东佛山528000 [2]广东省佛山市第一人民医院

出　　处：《中国医学创新》2018年第17期50-53,共4页Medical Innovation of China

基　　金：佛山市医学类科技攻关项目(201108055)

摘　　要：目的:探讨慢性肺源性心脏病合并心源性休克患者采用脉搏指示连续心输出量(PICCO)监测仪的临床效果及对患者血流动力学的影响。方法:选取2015年6月-2017年12月入院治疗的慢性肺源性心脏病合并心源性休克患者110例。根据治疗方法不同分为对照组和观察组,各55例。两组均采用常规方法治疗,对照组治疗过程中采用深静脉穿刺监测患者中心静脉压(CVP)水平,观察组在对照组基础上联合PICCO监测,两组均连续治疗72 h。比较两组血管活性药物使用时间、住院时间及机械通气时间;比较观察组治疗后不同时间点及不同预后的胸腔内血容量(ITBVI)、血管外肺水指数(EVLWI)、肺血管通透指数(PVPI)及心脏指数(CI)。结果:观察组活性药物使用、住院及机械通气时间均短于对照组,比较差异均有统计学意义(P<0.05);观察组治疗后不同时间点ITBVI水平比较差异无统计学意义(P>0.05);治疗后72 h,观察组PVPI、EVLWI水平均低于治疗后24、48 h,且治疗后48 h均低于治疗后24 h,比较差异均有统计学意义(P<0.05);治疗后72 h,观察组CI水平均高于治疗后24、48 h,且治疗后48 h均高于治疗后24 h,比较差异均有统计学意义(P<0.05);观察组治疗后预后良好43例,死亡12例;观察组不同预后下ITBVI水平比较,差异无统计学意义(P>0.05);预后良好者EVLWI水平低于死亡患者,PVPI及CI水平均高于死亡患者,比较差异均有统计学意义(P<0.05)。结论:慢性肺源性心脏病合并心源性休克患者采用PICCO监测效果理想,有助于提高临床疗效,改善患者血流动力学,值得推广应用。Objective：To explore the clinical effect of pulse indicator continuous cardiac output（PICCO） monitor and its effect on hemodynamics in patients with chronic pulmonary heart disease complicated by cardiogenic shock.Method：A total of 110 patients with chronic pulmonary heart disease complicated by cardiogenic shock from June 2015 to December 2017 were selected.According to different treatment methods,they were divided into control group and observation group,55 cases in each group.They were treated by routine treatment,deep venous puncture was used to monitor the central venous pressure（CVP） level in control group,and observation group was combined with PICCO monitoring on the basis of control group,they were continuously treated with 72 h.The vasoactive drugs use time,hospitalization time and duration of mechanical ventilation between two groups were compared.The intrathoracic blood volume（ITBVI）,extravascular lung water index（EVLWI）,pulmonary vascular permeability index（PVPI） and cardiac index（CI） in observation group at different time points after treatment and different prognosis were compared.Result：The vasoactive drugs use time,hospitalization time and duration of mechanical ventilation in observation group were shorter than those of control group,the differences were statistically significant（P〈0.05）.The level of ITBVI in observation group at different time points after treatment was compared,the difference was not statistically significant（P〉0.05）.After treatment 72 h,the levels of PVPI and EVLWI in observation group were lower than those after treatment 24 and 48 h,and after treatment 48 h were lower than those after treatment 24 h,the differences were statistically significant（P〈0.05）.After treatment 72 h,the level of CI in observation group was higher than those after treatment 24 and 48 h,and after treatment 48 h was higher than that of after treatment 24 h,the differences were statistically significant（P〈0.05）.In the observation group,43 cases had g

关 键 词：慢性肺源性心脏病 心源性休克 脉搏指示连续心输出量 血流动力学 

分 类 号：R541.5[医药卫生—心血管疾病]