重症超声联合PICCO技术容量管理对ARDS预后的影响  

Effects of fluid management using by critical ultrasound combined with PICCO technology on the prognosis of patients with ARDS

作　　者：卢燕[1] 李学莉[1] 张悦 姜城 LU Yan;LI Xueli;ZHANG Yue;JIANG Cheng(Intensive Care Unit,the First People’s Hospital of Yinchuan,Yinchuan 750001,China)

机构地区：[1]宁夏银川市第一人民医院重症医学科,宁夏银川750001 [2]宁夏医科大学,宁夏银川750004

出　　处：《宁夏医学杂志》2022年第3期223-226,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2020AAC03492);宁夏医科大学校级研究基金项目(XM2020028)。

摘　　要：目的探讨重症超声联合PICCO技术容量管理对ARDS预后的影响。方法选择ARDS机械通气患者60例,按照随机数字法分为研究组(重症超声联合PICCO技术组)和对照组(PICCO技术组),每组30例,分别收集2组病人基线资料,对比2组第1、3、5、7天的累积液体平衡量、氧合指数、中心静脉压(CVP)。收集患者机械通气时间、住ICU天数和28天病死率,对比2组各指标间的差异。结果研究组第1、3、5、7天累积液体正平衡低于对照组(P<0.05);研究组第1、3、5、7天氧合指数均高于对照组(P<0.05);研究组第1、3、5、7天CVP低于对照组(P<0.05);研究组机械通气时间、住ICU时间比对照组短(P<0.05),2组28天病死率比较差异无统计学意义(P>0.05)。结论相对于单纯PICCO监测技术,重症超声联合PICCO技术更有利于ARDS容量管理,是PICCO技术的良好补充,能更好改善氧合、缩短ARDS机械通气时间、缩短住ICU时间,但不能降低28天病死率。Objective To investigate the effect of fluid management using by critical ultrasound combined with PICCO technology on the prognosis of ARDS.Methods 60 patients with ARDS by mechanical ventilation were randomly divided into study group(Critical Ultrasound combined with PICCO technology group)and control group(PICCO technology group)and 30 cases in each group.Baseline information,mechanical ventilation time and length of ICU stay,28-day mortality were recorded.The amount of accumulated liquid balance,oxygenation index and CVP at 1,3,5 and 7d were also recorded.Results Compared with control group,the accumulated liquid balance of 1,3,5 and 7 days was lower in study group(P<0.05),the oxygenation index of 1,3,5 and 7 day were higher in study group than that of control group(P<0.05).CVP at 1,3,5 and 7d in the study group were lower than those in the control group(P<0.05).Compared with the control group,the study group had shorter mechanical ventilation time and shorter ICU stay time(P<0.05).There was no difference in 28-day mortality(P>0.05).Conclusion Critical ultrasound combined with PICCO technology is more conducive to ARDS fluid management and it is a better supplement to PICCO technology.It can improve oxygenation,shorten mechanical ventilation and ICU stay time,but it cannot reduce the 28-day mortality.

关 键 词：脉搏指示剂连续心排出量监测 技术 重症超声 容量管理 急性呼吸窘迫综合征 预后 

分 类 号：R730.41[医药卫生—肿瘤]