PICCO监测在脓毒症合并心功能不全患者治疗中的作用及应用价值  

Role and Application Value of PICCO Monitoring in the Treatment of Patients with Sepsis Complicated with Cardiac Insufficiency

作　　者：张清艳 杨宏锋 熊峰 卞正 ZHANG Qingyan;YANG Hongfeng;XIONG Feng;BIAN Zheng(Department of Critical Care Medicine,Zhenjiang First People's Hospital,Zhenjiang,Jiangsu Province,212000 China)

机构地区：[1]镇江市第一人民医院重症医学科,江苏镇江212000

出　　处：《系统医学》2023年第19期45-48,共4页Systems Medicine

基　　金：镇江市科技计划项目(SH2019066)。

摘　　要：目的探究脉搏指示连续心排血量(pulse indicator continuous cardiac output,PICCO)监测在脓毒症合并心功能不全患者治疗中的作用及应用价值。方法回顾性分析2020年1月—2022年12月镇江市第一人民医院收治的48例脓毒症合并心功能不全患者相关病历资料,基于治疗方案分为对照组(n=24)与研究组(n=24)。对照组予以常规容量管理,研究组予以PICCO监测并在此指导下进行容量管理,比较两组患者机械通气时间、重症监护室(intensive care unit,ICU)住院时间、各项体征数据、氧合指数以及乳酸相关指标。结果研究组患者机械通气时间(72.89±3.35)h、ICU住院时间(8.74±2.27)h均短于对照组,差异有统计学意义(t=13.016、2.080,P<0.05)。治疗前,两组各项体征数据比较,差异无统计学意义(P>0.05);治疗后,两组患者各项数据均较治疗前好转,研究组心率、血清乳酸浓度、补液量低于对照组,平均动脉压、氧合指数高于对照组,差异有统计学意义(P<0.05)。结论PICCO监测脓毒症合并心功能不全患者有利于缩短患者住院时间,促进患者预后转归。Objective To explore the role and application value of pulse indicator continuous cardiac output(PICCO)monitoring in the treatment of patients with sepsis complicated with cardiac insufficiency.Methods The relevant medical records of 48 patients with sepsis combined with cardiac insufficiency admitted to Zhenjiang First People's Hospital from January 2020 to December 2022 were retrospectively analyzed,and they were divided into control group(n=24)and study group(n=24)based on treatment plan.The control group was given routine volume management,while the study group was given PICCO monitoring and volume management under this guidance.Mechanical ventilation time,length of stay in intensive care unit(ICU),physical signs data,oxygenation index and lactate related indexes were compared between the two groups.Results The mechanical ventilation time(72.89±3.35)h and ICU stay time(8.74±2.27)h in the study group were shorter than those in the control group,the differences were statistically significant(t=13.016,2.080,P<0.05).Before treatment,there was no statistically significant difference in physical signs between the two groups(P>0.05).After treatment,all the data of the two groups were better than before treatment,the heart rate,serum lactate concentration and fluid rehydration in the study group were lower than those in the control group,and the mean arterial pressure and oxygenation index were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion PICCO monitoring in patients with sepsis combined with cardiac dysfunction is beneficial to shorten the length of hospital stay and promote the prognosis of patients.

关 键 词：脉搏指示连续心排血量监测 脓毒症 心功能不全 临床应用价值 

分 类 号：R459.7[医药卫生—急诊医学]