PICCO指导下导管留置在多发伤患者液体复苏中的应用  

Catheter Indwelling under PICCO for Fluid Resuscitation in Patients with Multiple Injuries

作　　者：刘冠雄 LIU Guanxiong(Yunfu People’s Hospital,Guangdong Province,Yunfu 527300,China)

机构地区：[1]广东省云浮市人民医院,广东云浮527300

出　　处：《中国医学创新》2022年第11期141-145,共5页Medical Innovation of China

基　　金：云浮市医学科学技术研究项目(2019B009)。

摘　　要：目的:探究PICCO指导下导管留置在多发伤患者液体复苏中的应用。方法:随机抽取2019年1月-2022年1月云浮市人民医院收治多发伤患者60例纳入研究。按照随机数字表法将患者分为对照组及治疗组,各30例。对照组开展中心静脉导管留置,治疗组开展PICCO动脉导管留置,两组均根据相关指标指导液体复苏。比较两组生理指标各时间点变化情况、液体复苏72 h疗效、临床指标。结果:治疗12 h(T_(2))、24 h(T_(3)),治疗组心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)水平均低于对照组,氧合指数(PaO_(2)/FiO_(2))均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组血管活性药物评分及APACHEⅡ评分比较,差异均无统计学意义(P>0.05);治疗后,治疗组血管活性药物评分及APACHEⅡ评分均较治疗前降低,且均低于对照组,差异均有统计学意义(P<0.05);对照组治疗前后上述指标比较,差异均无统计学意义(P>0.05)。治疗组72 h液体量、去甲肾上腺素使用量均少于对照组,呼吸机时间、ICU时间均短于对照组,28 d内病死率低于对照组,差异均有统计学意义(P<0.05)。结论:PICCO指导下导管留置在多发伤患者液体复苏中应用价值较高,具有一定推广价值。Objective:To explore the application of catheterization under PICCO guidance in fluid resuscitation in patients with multiple injuries.Method:Sixty patients with multiple injuries admitted to Yunfu People’s Hospital from January 2019 to January 2022 were randomly selected to be included in this study.Patients were divided into control group and treatment group according to random number table method,with 30 cases in each group.The control group received central venous indwelling and the treatment group received PICCO arterial catheterization.The changes of physiological indexes at each time point,the efficacy of fluid resuscations for 72 h and clinical indexes were compared between the two groups.Result:After 12 h(T_(2))and 24 h(T_(3))treatment,the heart rate(HR),mean arterial pressure(MAP)and central venous pressure(CVP)of the treatment group were lower than those of the control group,and the oxygenation index(PaO_(2)/FiO_(2))of the treatment group were higher than those of the control group,with statistical significances(P<0.05).Before treatment,there were no significant differences in vasoactive drug score and APACHEⅡscore between the two groups(P>0.05);after treatment,the scores of vasoactive drugs and APACHEⅡin the treatment group were lower than before treatment and lower than those in the control group,the differences were statistically significant(P<0.05);there were no significant differences in the above indexes before and after treatment in the control group(P>0.05).The 72 h fluid volume and the use of norepinephrine in the treatment group were lower than those in the control group,the ventilator time and ICU time were shorter than those in the control group,and the mortality within 28 d was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Catheterization under the guidance of PICCO has high application value in fluid resuscitation in patients with multiple injuries,and has certain promotion value.

关 键 词：PICCO 中心静脉导管留置 多发伤 液体复苏 

分 类 号：R641[医药卫生—外科学]