检验医学与临床2016，Vol.13Issue(5)：619-622,4.DOI:10.3969/j.issn.1672-9455.2016.05.017
脉搏指示连续心排血量监测在脓毒性休克患者早期液体复苏及治疗中的应用
Application of PiCCO monitoring in early fluid resuscitation and treatment of septic shock patients
摘要
Abstract
Objective To explore the clinical application value of the pulse indicated continuous cardiac output (PiCCO) monitoring in early fluid resuscitation and treatment of septic shock patients .Methods 50 patients with septic shock conforming to the inclusion criteria in our hospital from June 2013 to May 2015 were selected and ran‐domly divided into the study group and the control group according to the random number table method ,25 cases in each group .The study group was performed the fluid resuscitation and treatment under the guidance of PiCCO ,while the fluid resuscitation and treatment in the control group was guided by the central venous pressure (CVP) .The scores of acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ ) before and after treatment ,blood lactate clearance rate ,liquid quantity of resuscitation ,CVP ,urine volume ,MAP ,number of cases needing the mechani‐cal ventilation and cases of pulmonary edema and heart failure were observed in the two groups .Results The A‐PACHE Ⅱ scores after fluid resuscitation and treatment in the two groups were significantly decreased ,which at 72 h in the study group were significantly lower than that in the control group with statistical difference (P< 0 .05) .The fluid use amounts at 6 ,24 h in the study group were significantly more than those in the control group ,but the fluid total amounts at 72 h were significantly less than those in the control group ,the difference was statistically significant (P< 0 .05) ;the lactate clearance rate ,CVP ,urine volume and MAP at 6 ,24 h of treatment in the study group were superior to those in the control group ,the differences were statistically significant (P< 0 .05) .The number of cases of lung edema and heart failure occurrence at 72 h in the study group was significantly less than that in the control group with statistical difference (P< 0 .05) .No statistically significant difference in the cases number of using me‐chanical ventilation was found between the two groups (P> 0 .05) .Conclusion The PiCCO monitoring can more ac‐curately evaluate the volume status in the patients with septic shock ,precisely guides the fluid resuscitation and treat‐ment ,reduces the complications ,and has better guidance significance for the early fluid resuscitation and treatment in the patients with septic shock .关键词
脉搏指示连续心排血量监测/血流动力学/脓毒性休克/容量复苏Key words
PiCCO/hemodynamic/septic shock/fluid resuscitation引用本文复制引用
王家胜,陈勇,康小兰,胡大碧,况刚,杨秀江..脉搏指示连续心排血量监测在脓毒性休克患者早期液体复苏及治疗中的应用[J].检验医学与临床,2016,13(5):619-622,4.基金项目
2013年重庆市第六批科技计划项目（cstc2013jcsf10026）。 （）
