脉搏指示持续心排血量监测联合重症超声在感染性休克患者液体复苏中的应用价值  

Value of Pulse Indicating Continuous Cardiac Output Monitoring Combined with Severe Ultrasound in Fluid Resusci⁃tation of Septic Shock Patients

作　　者：刘科蓝 朱宇[1] 胡维 蒋益鹏 Liu Kelan;Zhu Yu;Hu Wei;Jiang Yipeng(Intensive Care Unit,Liyang People's Hospital,Liyang 213300,Jiangsu Province,China)

机构地区：[1]溧阳市人民医院重症医学科,江苏溧阳213300

出　　处：《中外医药研究》2024年第5期27-29,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析脉搏指示持续心排血量(PiCCO)监测联合重症超声在感染性休克患者液体复苏中的应用价值。方法:选取2017年9月—2023年6月溧阳市人民医院重症医学科收治的感染性休克患者80例为研究对象,随机分为观察组和对照组,各40例。对照组采用PiCCO监测联合中心静脉压(CVP)测定液体复苏,观察组采用PiCCO监测联合重症超声液体复苏。比较两组氧代谢指标[乳酸(Lac)、氧合指数(OI)、中心静脉血氧饱和度(ScVO_(2))]、液体总入量、临床相关指标。结果:治疗后6 h,两组ScVO_(2)、OI、Lac、液体总入量水平比较,差异无统计学意义(P>0.05);治疗后12 h,两组ScVO_(2)、OI、液体总入量升高,Lac降低,观察组ScVO_(2)、OI高于对照组,Lac、液体总入量低于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、入住ICU时间短于对照组,肺水肿发生率低于对照组,差异有统计学意义(P<0.05);两组治疗7 d后死亡率比较,差异无统计学意义(P>0.05)。结论:PiCCO监测联合重症超声方式在感染性休克患者液体复苏中应用效果较好,能够改善氧代谢指标,缩短机械通气时间、入住ICU时间,降低肺水肿发生率。Objective:To analyze the value of pulse indicating continuous cardiac output(PiCCO)monitoring combined with se⁃vere ultrasound in fluid resuscitation of septic shock patients.Methods:A total of eighty patients with septic shock admitted to In⁃tensive Care Unit of Liyang People's Hospital from September 2017 to June 2023 were selected as the study objects and randomly divided into observation group and control group,with forty cases in each group.The control group was treated with PiCCO moni⁃toring combined with central venous pressure(CVP),and the observation group was treated with PiCCO monitoring combined with ultrasonic liquid resuscitation.The oxygen metabolism indexes[lactic acid(Lac),oxygenation index(OI),central venous oxygen saturation(ScVO_(2))],total fluid intake and clinically relevant indexes were compared between the two groups.Results:At 6 h after treatment,there was no significant difference in ScVO_(2),OI,Lac and total fluid intake between the two groups(P>0.05);at 12 h af⁃ter treatment,ScVO_(2),OI and total fluid intake increased and Lac decreased in both groups,ScVO_(2) and OI in observation group were higher than those in control group,while Lac and total fluid intake were lower than those in control group,with statistical sig⁃nificance(P<0.05).The mechanical ventilation time and ICU stay time of observation group were shorter than control group,and theincidenceofpulmonaryedemawaslowerthancontrolgroup,thedifferencewasstatisticallysignificant(P<0.05);there was no sig⁃nificant difference in mortality between the two groups after 7 days of treatment(P>0.05).Conclusion:The application of PiCCO monitoring combined with severe ultrasound in fluid resuscitation of septic shock patients is effective,which can improve oxygen metabolism indexes,shorten the time of mechanical ventilation,stay in ICU,and reduce the incidence of pulmonary edema.

关 键 词：脉搏指示连续心排血量 重症超声 感染性休克 液体复苏 

分 类 号：R459.7[医药卫生—急诊医学]