重症急性胰腺炎腹内高压患者的PICCO监测与超声监测  

Clinical study of PICCO and ultrasonography in the diagnosis of intra-abdominal hypertension in patients with severe acute pancreatitis

作　　者：白准 曾维忠 彭苏娜 吴双华 刘旭丽 BAI Zhun;ZENG Wei-zhong;PENG Su-na;WU Shuang-hua;LIU Xu-li(Department of Critical Care Medicine,Zhuzhou Central Hospital,412000 Zhuzhou,Hunan,China)

机构地区：[1]株洲市中心医院重症医学科,湖南株洲412000

出　　处：《临床消化病杂志》2024年第3期193-196,共4页Chinese Journal of Clinical Gastroenterology

基　　金：湖南省卫生健康委科研计划课题项目(No:C2019198)。

摘　　要：[目的]探讨重症急性胰腺炎腹内高压患者脉搏指数连续心输出量(PICCO)监测与超声监测的临床研究。[方法]选择入住ICU的重症急性胰腺炎患者158例。所有患者均于入院后采用常规治疗,包括吸氧、胃肠减压、禁食禁饮、纠正水电解质代谢、维持酸碱平衡紊乱、预防感染等,且进行PICCO监测与超声监测。比较不同监测方法血流动力学监测准确度、腹内压、痊愈率、住院时间、APACHEⅡ评分、器官功能衰竭情况。[结果]PICCO联合超声组血流动力学监测准确度高于PICCO组、超声组,腹内压低于PICCO组、超声组,均差异有统计学意义(P<0.05);PICCO联合超声组痊愈率明显高于PICCO组、超声组,差异有统计学(P<0.05);PICCO联合超声组住院时间短于PICCO组、超声组,APACHEⅡ评分低于PICCO组、超声组,器官功能衰竭率低于PICCO组、超声组,均差异有统计学意义(P<0.05)。[结论]重症急性胰腺炎腹内高压患者PICCO与超声联合监测的临床效果明显,可提高血流动力学监测准确度、监测了可能引起治疗效果的改变,可以通过监测迅速改变治疗方案,方可引起预后的改变。[Objective]To investigate the clinical value of pulse induced contour cardiac output(PICCO)and ultrasonography in the diagnosis of intra-abdominal hypertension in patients with severe acute pancreatitis.[Methods]One hundred and fifty-eight patients with severe acute pancreatitis in ICU were selected.All patients were treated with conventional treatment,including oxygen inhalation,gastrointestinal decompression,fasting water,correct water electrolyte metabolism,maintaining acid-base balance,prevention of infection,and PICCO and ultrasound monitoring.The hemodynamic monitoring accuracy,intra-abdominal pressure,cure rate,hospitalization time,APACHEⅡscore and organ failure were compared.[Results]PICCO group combined with ultrasound hemodynamic monitoring accuracy was higher than that of PICCO group and ultrasound group,intra-abdominal pressure lower than the PICCO group and the ultrasound group(P<0.05);PICCO combined with ultrasound group cure rate was significantly higher than the PICCO group and the ultrasound group(P<0.05);PICCO ultrasound group was shorter than PICCO group and ultrasound group,APACHEⅡwas lower than that of PICCO group and ultrasound group,organ failure rate was lower than the PICCO group and the ultrasound group(P<0.05).[Conclusion]The clinical effect of PICCO combined with ultrasonic monitoring,in patients with abdominal hypertension severe acute pancreatitis can improve the hemodynamic monitoring accuracy,shorten the hospitalization time,improve the cure rate,reduce organ failure and reduce intra-abdominal pressure,has the important research significance.

关 键 词：重症急性胰腺炎 腹内高压 脉搏指数连续心输出量 超声监测 

分 类 号：R576[医药卫生—消化系统]