摘要
目的:探讨监测其脉搏指示连续心排血量(Pi CCO)对脓毒性休克患者临床治疗的意义。方法:选取2014年3月至2016年9月来海南省万宁市人民医院、广东省人民医院治疗的126例脓毒性休克患者,随机分配为观察组患者63例,对照组患者63例,观察组患者监测Pi CCO,对照组患者采用传统监测方式,记录观察组和对照组患者进入重症监护病房(ICU)治疗后6 h、3 d后体内的液体总量、急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)及患者刚进ICU时和治疗3 d后血浆氨基酸B型钠尿肽前体(NT-pro-BNP)和中心静脉压(CVP)的差值,两组使用呼吸机进行机械通气、住重症病房天数,28 d内的病死率,并对以上参数进行分析比较。结果:观察组患者在治疗3 d后APACHEⅡ评分、呼吸机支持时间、住院天数均小于对照组,住院3 d后的前后水平差值NT-pro-BNP大于对照组,差值CVP小于对照组,差异具有统计学意义(P<0.05)。两组6 h补液量、3 d补液量、28 d内病死率对比,差异均无统计学意义(P>0.05)。结论:监测Pi CCO结合早期目标导向治疗(EGDT)能够有效指导临床精确治疗,缩短患者住ICU及使用呼吸机的时间。
Objective To observe the significance of continuous cardiac output （PiCCO） in the treatment of patients with septic shock and to explore the significance of pulse pressure in clinical treatment. Methods From March 2014 to September 2016, 126 patients with septic shock who were treated in Wanning City People＇s Hospital of Guangdong Province and Guangdong Provincial People＇s Hospital were randomly assigned to 63 patients in the observation group and 63 patients in the control group. The patients in the observation group were monitored by PiCCO. The patients in the control group were treated with traditional monitoring methods. The total fluid volume, acute physiology and chronic health status of the patients in the observation group and the control group were recorded at 6 h and 3 d after treatment with the ICU. （NT-pro-BNP） and central venous pressure （CVP） after 3 months of treatment with APACHE Ⅱ and the patients were treated with mechanical ventilation, The number of days of intensive care ward, the mortality rate within 28 days, and the above parameters were analyzed and compared. Results： The APACHE II score, the duration of ventilator support and the number of hospital stay were significantly lower in the observation group than in the control group after 3 days of treatment. The difference of the level of plasma amino acid B-type natriuretic peptide （ Δ NT-pro-BNP） （P 〈 0.05）. The difference of central venous pressure （ Δ CVP） was smaller than that of the control group （P 〈 0.05）. There was no significant difference in the mortality of the two groups （P 〈 0.05）. Conclusion： Monitoring of PiCCO combined with early target-oriented therapy （EGDT） can effectively guide clinical precise treatment, shorten the time of ICU and the use of ventilator.
出处
《深圳中西医结合杂志》
2017年第14期32-34,共3页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
