PICCO指导液体负平衡治疗感染性休克患者的早期复苏及预后影响研究  

PICCO study on early recovery and prognosis of liquid negative balance in patients with septic shock

作　　者：古丽玲 Gu Liling(The People's Hospital of Xinfeng County,Xinfeng,Jiangxi341600)

机构地区：[1]信丰县人民医院,江西信丰341600

出　　处：《基层医学论坛》2021年第35期5038-5040,共3页The Medical Forum

基　　金：赣州市指导性科技计划项目(GZ2020ZSF523)。

摘　　要：目的分析脉搏指示连续心排血量监测(PICCO)指导液体负平衡治疗感染性休克患者的早期复苏及预后影响。方法选取2020年7月—12月信丰县人民医院感染性休克患者74例,按治疗方法不同分为研究组(n=37)与对照组(n=37),对照组采用PICCO指导液体复苏治疗,研究组采用PICCO指导液体负平衡治疗,对比2组平均动脉压(MAP)、全心舒张末期容量指数(GED-CVI)、血清炎性因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、急性生理与慢性健康状况评分(APACHEⅡ)、预后情况。结果治疗后3 d、治疗后6 d,研究组MAP水平较对照组高(P<0.05);治疗后3 d、治疗后6 d,研究组GED-CVI较对照组高(P<0.05);治疗后3 d、治疗后6 d,研究组血清TNF-α、IL-1β水平较对照组低(P<0.05);治疗后1 d、治疗后3 d、治疗后6 d,研究组APACHEⅡ评分较对照组低(P<0.05);研究组病死率2.70%(1/37)与对照组13.51%(5/37)对比无显著差异(P>0.05)。结论PICCO指导液体负平衡治疗感染性休克患者,可改善血压水平和心功能,缓解炎症状态,减轻病情严重程度,改善预后。Objective To analyze the effect of PICCO on liquid negative balance for early recovery and prognosis in patients with septic shock.Methods 74 patients with septic shock in December 2020~December 2020,divided into study group(n=37)and control group(n=37),PICCO guided liquid negative balance treatment,compared two groups of mean arterial pressure(MAP),total end diastolic volume index(GED-CVI),serum inflammatory factor level[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)]and prognosis.Results 3 days and 6 days after treatment,the MAP level in the study group was higher than that in the control group(P<0.05).3 days and 6 days after treatment,GED-CVI in the study group was higher than that in the control group(P<0.05).3 days and 6 days after treatment,the levels of TNF-αand IL-1βin the study group were lower than those in the control group(P<0.05).1 day,3 days and 6 days after treatment,the APACHEⅡscore of the study group was lower than that of the control group(P<0.05).There was no significant difference in mortality between 2.70%(1/37)of study group and 13.51%(5/37)of control group(P>0.05).Conclusion PICCO guides liquid negative balance in patients with infectious shock to improve blood pressure level and cardiac function,relieve inflammation and improve prognosis.

关 键 词：感染性休克 脉搏指示连续心排血量监测 液体负平衡治疗 平均动脉压 全心舒张末期容量指数 炎性因子 

分 类 号：R631.4[医药卫生—外科学]