PiCCO与CVP监测下液体复苏治疗脓毒症休克合并重度急性呼吸窘迫综合征的临床效果比较  

Comparison of Clinical Effects of Fluid Resuscitation under PiCCO and CVP Monitoring in the Treatment of Septic Shock Complicated with Severe Acute Respiratory Distress Syndrome

作　　者：蔡晓扬[1] 宁耀贵[1] 孙杰 CAI Xiaoyang;NING Yaogui;SUN Jie(Department of Critical Care Medicine,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China;不详)

机构地区：[1]厦门大学附属第一医院重症医学科,福建厦门361000

出　　处：《中国医学创新》2024年第9期6-10,共5页Medical Innovation of China

摘　　要：目的:比较给予脓毒症休克(SS)合并重度急性呼吸窘迫综合征(ARDS)患者脉搏指示连续心排血量(PiCCO)与中心静脉压(CVP)监测下液体复苏治疗的临床效果。方法:选取2018年1月—2022年12月厦门大学附属第一医院收治的SS合并重度ARDS患者共计100例,以随机数字表法分成研究组(n=50)与对照组(n=50)。对照组给予CVP监测下液体复苏治疗,研究组给予PiCCO监测下液体复苏治疗。比较两组复苏目标达标率、生命体征、代谢指标、转归情况。结果:研究组治疗6 h后的复苏目标达标率较对照组更高,差异有统计学意义(P<0.05);两组治疗24 h后尿量(UO)、平均动脉压(MAP)均提高,心率(HR)均降低,研究组UO、MAP均较对照组更高,HR更低,差异均有统计学意义(P<0.05);两组治疗24 h后中心静脉血氧饱和度(ScvO_(2))均升高,乳酸(Lac)水平均降低,研究组ScvO_(2)较对照组更高,Lac更低,差异均有统计学意义(P<0.05);研究组血管活性药物使用时间、抗生素使用时间、机械通气时间、重症监护室(ICU)停留时间均较对照组更短,差异均有统计学意义(P<0.05)。结论:相较于CVP监测,给予SS合并重度ARDS患者PiCCO监测下液体复苏治疗,能够提高复苏目标达标率,维持生命体征,改善代谢指标,促进患者恢复。Objective:To compare the clinical effects of fluid resuscitation therapy under pulse indicator continuous cardiac output(PiCCO)and central venous pressure(CVP)monitoring in patients with septic shock(SS)complicated with severe acute respiratory distress syndrome(ARDS).Method:A total of 100 patients with SS complicated with severe ARDS admitted to the First Affiliated Hospital of Xiamen University from January 2018 to December 2022 were selected and divided into study group(n=50)and control group(n=50)according to random number table method.The control group was given liquid resuscitation therapy under CVP monitoring,and the study group was given liquid resuscitation therapy under PiCCO monitoring.The rate of achievement of resuscitation goal,vital sign,metabolic indexes and sequelae situation were compared between the two groups.Result:After 6 h of treatment,the rate of achievement of resuscitation goal of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).After 24 h of treatment,urine volume(UO)and mean arterial pressure(MAP)increased and heart rate(HR)decreased in both groups,and UO and MAP in the study group were higher than those in the control group,and HR in the study group was lower than that in the control group,the differences were statistically significant(P<0.05).After 24 h of treatment,central venous blood oxygen saturation(ScvO_(2))increased and lactate(Lac)levels decreased in both groups,and ScvO_(2) in study group was higher than that in control group,Lac in study group was lower than that in control group,the differences were statistically significant(P<0.05).The vasoactive drug use time,antibiotic use time,mechanical ventilation time and ICU stay time in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with CVP monitoring,liquid resuscitation therapy under PiCCO monitoring for patients with SS complicated with severe ARDS can improve the rate of achiev

关 键 词：脓毒症休克 重度急性呼吸窘迫综合征 脉搏指示连续心排血量 中心静脉压 液体复苏 

分 类 号：R459.7[医药卫生—急诊医学] R563.8[医药卫生—治疗学]