漂浮导管对重症急性胰腺炎继发脓毒血症患者临床治疗的价值研究  

Values of Floating Catheter to Treat Sepsis Secondary to Severe Acute Pancreatitis

作　　者：张丽涓[1] 沈钦[1] 陈淘江 向相 李雪莲[1] Zhang Lijuan;Shen Qin;Chen Taojiang(Department of Critical Care Medicine,Chengdu Fifth People′s Hospital,Chengdu,Sichuan 611130,China)

机构地区：[1]成都市第五人民医院重症医学科,四川成都611130

出　　处：《四川医学》2021年第1期10-13,共4页Sichuan Medical Journal

基　　金：四川省卫生和计划生育委员会科研课题(编号:120527)。

摘　　要：目的探讨分析漂浮导管技术对指导重症急性胰腺炎继发脓毒血症患者临床治疗的价值研究。方法选取2017年1月至2019年4月我院收治的重症急性胰腺炎继发脓毒血症患者60例,跟踪病情变化,其中病情好转患者40例(A组),病情恶化患者20例(B组)。对比观察两组患者的治疗前后48 h的中心静脉压(CVP)、平均肺动脉压(MPAP)、肺毛细血管楔压(PCWP)、心率(HR)、心脏指数(CI)、外周血管阻力指数(SVRI)等指标的血流动力学变化,同时观察记录病情好转组治疗后1~6 d的血流动力学改变。结果相比于治疗前,A组患者治疗48 h后CVP、CI指标明显下降(P<0.05),SVRI、HR、PCWP、MPAP指标明显升高(P<0.05);B组患者治疗前后血流动力学指标差异均无统计学意义(P>0.05)。与对照值相比,A组患者治疗后1~3 d CI、CVP明显降低(P<0.05),PCWP、SVRI明显升高(P<0.05);治疗后4~6 d内SVRI明显降低(P<0.05);治疗后6 d内MPAP和HR明显升高(P<0.05)。结论漂浮导管技术应用于重症急性胰腺炎继发脓毒血症患者,能够及时检测外周血管扩张和低血容量的问题,评估病情,在临床治疗的监测指导和预后评估有着重要价值。Objective To explore and analyze values of floating catheter technology in guiding clinical treatment of patients with sepsissecondary to severe acute pancreatitis(SAP).Methods From January 2017 to April 2019,60 patients with sepsis secondary to SAP admitted to our hospital were selected.Changes in their condition were tracked that 40 patients with improved condition(group A)and 20 patients with worsening condition(Group B).At 48 h before and after treatment,central venous pressure(CVP),mean pulmonary artery pressure(MPAP),pulmonary capillary wedge pressure(PCWP),heart rate(HR),cardiac index(CI),systemic vascular resistance index(SVRI)and other factors in two groups were observed and recorded.Hemodynamic changes of group A at 1 to 6 d after treatment were also compared.Results Compared with before treatment,for group A,CVP and CI were significantly decreased at 48 h after treatment(P<0.05),and SVRI,HR,PCWP and MPAP were significantly increased(P<0.05).There was no statistically significant difference in fluid dynamicsindexes(P>0.05).Compared with control values,CI and CVP of group A were significantly reduced at 1 to 3 d after treatment(P<0.05),and PCWP and SVRI were significantlyincreased(P<0.05).SVRI wasreduced at 4 to 6 d after treatment(P<0.05).MPAP and HR were increased significantly at 6 d after treatment(P<0.05).Conclusion Floating catheter technology is applied to patients with sepsis secondary to SAP.It could detect peripheral vascular dilatation and hypoglycemia to evaluate condition,which has important values to monitor guide and prognosis evaluationin clinical treatment.

关 键 词：漂浮导管 重症急性胰腺炎继发脓毒血症 价值 监测 

分 类 号：R576[医药卫生—消化系统]