脉波指示连续心排量监测(PICCO)技术在多发伤患者液体复苏中的应用效果

doi:10.3969/j.issn.1006-6233.2018.11.015

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摘要 目的: 探讨脉波指示连续心排量监测(PICCO)技术在多发伤患者液体复苏中的应用效果。方法: 收集2017年3月至2018年3月入院的80例多发伤液体复苏患者随机分为两组,对照组患者给予传统TTE与CVP监测,PICCO组患者则给予PICCO处理,比较两组患者监测期间相关生命指证与临床观察指标。结果: PICCO组患者T2与T3时段的HR、CVP、MAP、CI、GEF、GEDVI、ITBVI、EVLWI、LAC与APACHEⅡ评分组间比较均显著性低于对照组,PaO₂/FiO₂水平均显著性高于对照组;72h液体量、呼吸机时间、去甲肾上腺素使用量与ICU时间均显著性低于对照组,差异具有统计学意义(P<0.05)。结论: 脉波指示连续心排量监测技术在多发伤患者液体复苏中的应用效果显著,具有借鉴意义。

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	李强
	张书培
	王磊

关键词 ： PICCO, 多发伤, 液体复苏, CVP, TTE

Abstract：Objective: To investigate the application of Pulsed Wave Indicating Continuous Cardiac Output Monitoring (PICCO) technology in fluid resuscitation from multiple trauma patients. Methods: 80 patients with multiple traumatic fluid resuscitation who were admitted from March 2017 to March 2018 were randomly divided into two groups. Patients in the control group were given traditional TTE and CVP monitoring. Patients in the PICCO group were treated with PICCO. The life related evidence and clinical observation index of the two groups during the monitoring period were compared. Results:The HR, CVP, MAP, CI, GEF, GEDVI, ITBVI, EVLWI, LAC, and APACHEII scores in the PICCO group were significantly lower than those in the control group at the time of T2 and T3, and the PaO₂/FiO₂ levels were significantly higher than those in the control group. The control group; 72h liquid volume, ventilator time, norepinephrine use, ICU time and mortality at 28 days were significantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion:The application of pulse wave indication continuous cardiac output monitoring technique in fluid resuscitation of patients with multiple trauma is significant and has reference significance.

Key words： PICCO Multiple injuries Fluid resuscitation CVP TTE

基金资助:陕西省卫生厅科研基金项目,(编号:2014JM40364)

通讯作者: 张书培

引用本文:

李强,张书培,王磊. 脉波指示连续心排量监测(PICCO)技术在多发伤患者液体复苏中的应用效果[J]. 河北医学, 2018, 24(11): 1821-1823.
LI Qiang, ZHANG Shupei, et al. Application of Pulsed Wave Indicating Continuous Cardiac Output Monitoring (PICCO) Technique in Liquid Resuscitation of Multiple Trauma Patients. HeBei Med, 2018, 24(11): 1821-1823.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.11.015 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I11/1821