摘要
目的探讨脉搏指示连续心排血量监测（PICCO）技术在骨盆骨折患者血流动力学监测中应用的价值。方法选择32例因骨盆骨折入住急诊重症监护室的患者，通过PICCO技术即经肺热稀释方法和脉搏轮廓分析法监测心指数（CI）、全心舒张末期容积指数（GEDI）、胸腔内血容积指数（ITBI）、血管外肺水指数（ELwI）、心功能指数（CFI）、平均动脉压（MAP）和全身血管阻力指数（SVRI），记录液体复苏前后以上指标的变化。结果复苏前CI、ITBI、CFI、GEDI均显著降低，随着液体复苏进行，伤后48h各项指标均逐渐趋于正常（均P〈0．05），ELWI、GEF、MAP、SVRI、CVP于复苏前后均无明显变化（均P〉0．05）患者骨盆骨折后复苏前CI、ITBI、CFI、GEDI较复苏后明显降低（P〈0．05）；而ELWI、MAP、SVRI于复苏前后无明显变化（P〉0．05）。结论CI、ITBI、CFI、GEDI及其容量复苏后的变化能准确、可靠地评估患者容量状态，对骨盆骨折患者的液体管理具有重要价值。
Objective To investigaye the clinical value of pulse-indicated continuous cardiac output （PICCO） system in hemodynamic monitoring of patients with pelvic fractures. Methods 32 pelvic fracture patients admitted into the emergency intensive care unit （EICU） underwent monitiring by transpulmonary thermodilution PICCO technique. The levels of cardiac index （CI）, global end-diastolic volume index （GEDVI）, intra-thoracic blood volume index （ITBI）, extravascular lung water index （ELWI）, cardiac function index, （CFI）, mean artery pressure（MAP）, and systemic vascular resistance index （MAP）were recorded before and after the fluid resuscitation. Results The levels of CI, ITBI, CFI, and GEDVI of the pelvic fracture patients were all significantly low before resuscitation, however, these levels were all significantly higher than those before the fluid resuscitation （all P〈0.05）.No significant changes were found in the levels of ELWI, MAP,and SVRI. Conclusion The changes of the levels of CI,1TBI,CFI,GEDVI can be used to accurately and dependably assess the blood volume status of pelvic fracture patients and are useful for their fluid managements.
出处
《中国急救复苏与灾害医学杂志》
2013年第3期220-222,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
辽宁省自然科学基金：沈阳市科技攻关项目与picco相关的急危重症血流动力学研究（20091972）
