CAJ | 학술논문

目的：比较PiCCO（脉搏指示连续心输出量测定）监测与传统监测在脓毒性休克患者中的应用疗效及PiCCO监测的EVLWI值与治疗疗效相关性。方法分析2011年1月至2013年1月在该院监护病房接受治疗的脓毒性休克患者的临床资料；根据监测方法分为PiCCO监测组和常规监测组。并对PiCCO组患者根据入组时EVLWI值分为A组（EVLWI值≤7），B组（EVLWI值为7～12）和C组（EVLWI值≥12）三组，观察三组患者的预后。结果入组患者120例，其中PiCCO组56例，常规组64例，A组26例，B组16例，C 组14例。PiCCO组和常规组入组时、72 h时的CVP、MAP值均无统计学差异（P均＞0．05），而24h时两组CVP值和MAP值均有明显的差异（P均＜0．05）；一周后PiCCO组患者的CRP（t＝2．078，P＝0．036）、IL-6（t＝2．450，P＝0．016）和PCT（t＝5．324，P＜0．01）水平低于常规组；PiCCO组预后（一周时）优于常规组（χ2＝4．627，P＝0．031）；A、B、C三组患者治疗有效率差异有着统计学意义（χ2＝6．087，P＝0．048），EVLWI值越小，预后愈佳。结论 PiCCO组患者的CVP、MAP值恢复正常的速度、炎症指标下降速度和治疗有效率均优于常规组，且PiCCO组EVLWI值与最终治疗有效率有着明显的相关性，EVLWI值越小，预后愈佳。
목적：비교PiCCO（맥박지시련속심수출량측정）감측여전통감측재농독성휴극환자중적응용료효급PiCCO감측적EVLWI치여치료료효상관성。방법분석2011년1월지2013년1월재해원감호병방접수치료적농독성휴극환자적림상자료；근거감측방법분위PiCCO감측조화상규감측조。병대PiCCO조환자근거입조시EVLWI치분위A조（EVLWI치≤7），B조（EVLWI치위7～12）화C조（EVLWI치≥12）삼조，관찰삼조환자적예후。결과입조환자120례，기중PiCCO조56례，상규조64례，A조26례，B조16례，C 조14례。PiCCO조화상규조입조시、72 h시적CVP、MAP치균무통계학차이（P균＞0．05），이24h시량조CVP치화MAP치균유명현적차이（P균＜0．05）；일주후PiCCO조환자적CRP（t＝2．078，P＝0．036）、IL-6（t＝2．450，P＝0．016）화PCT（t＝5．324，P＜0．01）수평저우상규조；PiCCO조예후（일주시）우우상규조（χ2＝4．627，P＝0．031）；A、B、C삼조환자치료유효솔차이유착통계학의의（χ2＝6．087，P＝0．048），EVLWI치월소，예후유가。결론 PiCCO조환자적CVP、MAP치회복정상적속도、염증지표하강속도화치료유효솔균우우상규조，차PiCCO조EVLWI치여최종치료유효솔유착명현적상관성，EVLWI치월소，예후유가。
Objective Our retrospective study was aimed toanalyze the difference of efficiency of PiCCO and traditional monitor.Meth-ods Clinical data of patients with septic shockreceived treatment at our hospitalfrom 2011 to 2013 was retrospectivelyanalyzed.Theywere divided into PiCCO group (consist of A,B and C according to the value of EVLWI)and tradition group due to the different moni-tor ways.Results A total of 120 patients were retrospective analyzed.The PiCCO grouphadsuperiority over the tradition group in thespeed of retrieval of CVP and MAP,the decline rate and the efficacy.Conclusion The PiCCO group had superiority over the traditiongroup in the speed of retrieval of CVP and MAP,the decline rate and the efficacy.