无创心排血量监测联合心脏超声在心脏术后液体管理中的应用  

Application of non-invasive cardiac output monitoring combined with cardiac ultrasonopgraphy in fluid management after cardiac surgery

作　　者：何文娟[1] 王金柱[1] 刘景全[1] 叶瑞忠[2] 吴静[1] 姚惠萍[1] He Wenjuan;Wang Jinzhu;Liu Jingquan;Ye Ruizhong;Wu Jing;Yao Huiping(Intensive Care Unit,Zhejiang Provincial People′s Hospital,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院重症医学科,浙江杭州310014 [2]浙江省人民医院超声医学科,浙江杭州310014

出　　处：《护理学杂志》2024年第11期24-27,共4页Journal of Nursing Science

基　　金：浙江省医药卫生科技计划项目(2023KY056)。

摘　　要：目的提高心脏疾病术后患者液体管理效果,促进患者康复。方法将95例体外循环下心脏手术治疗患者随机分为对照组48例、干预组47例。两组均于术后进入ICU,对照组行常规液体管理,干预组实施无创心排血量监测联合心脏超声为核心的液体管理。结果干预组术后气管插管时间显著短于对照组,出科时左室射血分数、N端B型钠尿肽原值显著优于对照组(均P<0.05);干预组乳酸清除率、术后尿量显著高于或多于对照组,利尿剂使用率、机械通气时间和ICU停留时间显著少于或短于对照组(均P<0.05)。结论无创心排血量监测联合心脏超声用于心脏术后患者液体管理,可有效改善心功能,缩短机械通气时间,有利于患者康复。Objective To improve fluid management outcomes in postoperative patients after cardiac surgery and to promote patient recovery.Methods A total of 95 patients who underwent cardiac surgery under cardiopulmonary bypass were divided into a control group of 48,receiving usual fluid management,or an intervention group of 47,receiving fluid management using non-invasive cardiac output monitoring in combination with cardiac ultrasound.Results Compared with the control group,the intervention group had significantly shorter endotracheal intubation time,mechanical ventilation time and length of stay in the ICU,higher LVEF and lower NT-proBNP at discharge from the ICU,increased lactate clearance and postoperative urine volume,as well as reduced rate of use of diuretics(all P<0.05).Conclusion Combination use of non-invasive cardiac output monitoring and cardiac ultrasound in fluid management in patients undergoing cardiac surgery can effectively improve cardiac function and shorten mechanical ventilation time,resulting in beneficial effects on patient recovery.

关 键 词：心脏疾病 手术 液体管理 无创心排血量监测 心脏超声 心外科护理 

分 类 号：R473.6[医药卫生—护理学]