中国实用内科杂志2024，Vol.44Issue(3)：223-227,5.DOI:10.19538/j.nk2024030109
下腔静脉变异率联合脉搏指示连续心排血量在心肌梗死后心源性休克容量管理中应用研究
Study on the application of the variation rate of inferior vena cava combined with PiCCO in volume management of cardiogenic shock after myocardial infarction
摘要
Abstract
Objective To investigate the value of monitoring inferior vena cava variation rate(IVCV)and pulse indicating continuous cardiac output(PiCCO)in fine volume management of patients with cardiogenic shock after myocardial infarction.Methods A total of ninety patients with cardiogenic shock after myocardial infarction admitted to the Second Hospital of Shijiazhuang City from February 2019 to February 2022 were included as research subjects,and they were divided into groups according to intervention methods.The control group received routine intervention,and the observation group received fine volume management intervention under the monitoring of the variation rate of inferior vena cava and PiCCO.Results After 72 h of treatment,the N-terminal brain natriuretic peptide precursor(NT-proBNP),lactate level(Lac),oxygenation index(PaO2/FiO2),24 h urine volume,mean arterial pressure(MAP),heart index(CI),heart function index(CFI),stroke volume index(SVI)and total ejection fraction(GEF)in observation group were significantly better than those in control group(P＜0.05),and the variation rate of inferior vena cava in observation group was significantly higher than that in control group(P＜0.05).After 72 h of treatment,the acute physiological and chronic health score(APACHE-Ⅱ)of the observation group was significantly lower than that of the control group,and the total effective rate was significantly higher than that of the control group(97.78％vs.77.78％,P＜0.05).Conclusion Monitoring the variation rate of inferior vena cava and PiCCO in fine volume management of patients with cardiogenic shock after myocardial infarction can improve the hemodynamics and inferior vena cava status of patients,improve the clinical treatment effect and the quality of patient health management,increase the survival rate and reduce the mortality rate.关键词
容量管理/心源性休克/心肌梗死后心源性休克/下腔静脉变异率/脉搏指示连续心输出量/血流动力学Key words
volume management/cardiogenic shock/cardiogenic shock after myocardial infarction/variation rate of inferior vena cava/pulse indicating continuous cardiac output/hemodynamics分类
医药卫生引用本文复制引用
吕云玲,卢娜,张明明,王妍,张兴,游道锋..下腔静脉变异率联合脉搏指示连续心排血量在心肌梗死后心源性休克容量管理中应用研究[J].中国实用内科杂志,2024,44(3):223-227,5.基金项目
河北省卫健委课题(No.20190416) （No.20190416）
