重症超声联合PICCO在感染性休克液体复苏的临床应用  

Clinical Application of Severe Ultrasound Combined with PICCO in Septic Shock Fluid Resuscitation

作　　者：张欢欢 Zhang Huanhuan(Cardiac Intensive Care Unit,Zhengzhou Seventh People's Hospital,Zhengzhou 450000 China)

机构地区：[1]郑州市第七人民医院心脏重症监护室

出　　处：《锦州医科大学学报》2019年第6期32-34,共3页Journal of Jinzhou Medical University

基　　金：2018年度河南省医学科技攻关计划项目，项目编号:2018020865

摘　　要：目的研究重症超声(sonosite,M-TURBO)联合连续心输出量测定(PICCO)监测技术指导下感染性休克液体复苏中的应用价值。方法随机数表法将本院2016年2月至2018年4月诊治的80例感染性休克患者分为观察组与对照组,各40例,对照组给予PICCO检测技术联合中心静脉压(CVP)帮助患者进行液体复苏,观察组给予组重症超声联合PICCO帮助患者复苏。观察并比较两组患者液体复苏总输入量、机械通气时间和住院时间,治疗前后氧合指数、CVP和血乳酸水平,患者肺水肿发生率和治疗7 d后死亡率。结果与治疗前比较,两组治疗后氧合指数和CVP明显上升,血乳酸水平明显下降(P<0.05);观察组治疗后氧合指数和CVP明显高于对照组,血乳酸水平明显低于对照组;观察组患者复苏液体总输入量、机械通气时间和住院时间明显小于对照组(P<0.05);观察组治疗过程中肺水肿发生率明显低于对照组(P<0.05),治疗7 d后死亡率低于对照组,但差异无统计学意义(P>0.05)。结论重症超声联合PICCO指导应用于感染性休克患者的液体复苏效果好,能有效减少液体输入总量,改善患者心肺功能。Objective To study the application value of severe ultrasound combined with pulse indicated continuous cardiac output(PICCO)monitoring technique in septic shock fluid resuscitation.Methods 80 patients with septic shock diagnosed and treated in our hospital from February 2016 to April 2018 were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The control group were given PICCO detection technique combined with central venous pressure(CVP)to help them conduct fluid resuscitation while the observation group were given severe ultrasound combined with PICCO to help them recover.The total input quantity of fluid resuscitation,mechanical ventilation time and hospitalization time,oxygenation index,CVP and blood lactate levels before and after treatment as well as incidence of pulmonary edema and mortality at 7 d after treatment were observed and compared between the two groups.Results Compared with those before treatment,oxygenation index and CVP significantly increased after treatment in both groups,while blood lactate level significantly decreased(P<0.05),after treatment,oxygenation index and CVP of the observation group were significantly higher than those of the control group,while blood lactate level was significantly lower than that of the control group;the total input quantity of fluid resuscitation,mechanical ventilation time and hospitalization time in the observation group were significantly less than that in the control group(P<0.05),the incidence of pulmonary edema in the observation group was significantly lower than that in the control group during treatment period(P<0.05),and mortality was lower than that in the control group at 7 d after treatment(P>0.05).Conclusion The effect of fluid resuscitation in patients with septic shock guided by severe ultrasound combined with PICCO is good,which can effectively reduce the total amount of fluid input and improve the cardiopulmonary function of patients.

关 键 词：重症超声 连续心输出量测定 感染性休克 液体复苏 

分 类 号：R459.7[医药卫生—急诊医学]