优化血流动力学监测对重型颅脑损伤患者容量管理的探讨  

Optimization of hemodynamic monitoring for volume management of patients with severe craniocerebral injury

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作  者:李俊蕾[1] 李春玲[1] 陆蓉[1] 刘植丹 LI Jun-lei;LI Chun-ling;LU Rong;LIU Zhi-dan(Sichuan Provincial People's Hospital,Sichuan Chengdu 610072)

机构地区:[1]四川省人民医院,四川成都610072

出  处:《实用临床护理学电子杂志》2020年第29期5-6,共2页Electronic Journal of Practical Clinical Nursing Science

摘  要:目的探讨采用肺热稀释技术和脉搏波型轮廓分析技术(PiCCO),优化重型颅脑损伤患者的容量管理对患者临床和预后的影响。方法回顾分析我院2014.01-2016.01两年间特重型颅脑损伤患者,根据是否使用PiCCO分成优化组和对照组。对两组患者的液体平衡,中心静脉压,平均动脉压,机械通气天数,ICU住院日进行分析。同时针对优化组所有患者的血流动力学参数进行相关性分析。结果优化组和对照组在中心静脉压、平均动脉压都没有统计学差异,但两组患者的机械通气天数,ICU住院日有统计学差异(P<0.05),且优化组组内分析,全心舒张末期容积指数与中心静脉压相关系数r=0.28,无明显相关,但患者的血管外肺水指数,与全心舒张末期容积指数,机械通气天数,ICU住院日有明显相关性。结论优化血流动力学检测可以改善重型颅脑损伤患者的液体管理,从而缩短机械通气天数和ICU住院日。且全心舒张末期容积指数较中心静脉压,平均动脉压更好的反应患者的容量状况。Objective To explore the effect of lung thermal dilution and pulse wave profile analysis(PiCCO)on the clinical and prognosis of patients with severe craniocerebral injury.Methods the patients with severe craniocerebral injury in our hospital from January 2014 to January 2016 were retrospectively analyzed and divided into optimization group and control group according to whether or not to use PiCCO.The fluid balance,central venous pressure,mean arterial pressure,days of mechanical ventilation and ICU stay were analyzed.At the same time,the hemodynamic parameters of all patients in the optimization group were analyzed.Results There was no significant difference in central venous pressure and mean arterial pressure between the optimization group and the control group,but there were significant differences in the days of mechanical ventilation and ICU hospitalization days between the two groups(P<0.05),and the correlation coefficient between the global end diastolic volume index and central venous pressure was r=0.28,which was not significantly correlated with the extravascular lung water index and the global end diastolic volume index The number of days of mechanical ventilation and the length of stay in ICU were significantly correlated.Conclusion optimization of hemodynamic detection can improve the fluid management of patients with severe craniocerebral injury,and shorten the days of mechanical ventilation and ICU hospitalization.And the global end diastolic volume index is better than central venous pressure and mean arterial pressure to reflect the volume status of patients.

关 键 词:血流动力学 特重型颅脑损伤 容量管理 

分 类 号:R47[医药卫生—护理学]

 

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