国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
17期
1305-1307
,共3页
脉搏指示连续心排血量%急性呼吸窘迫综合征%病死率%血管外肺水%液体管理
脈搏指示連續心排血量%急性呼吸窘迫綜閤徵%病死率%血管外肺水%液體管理
맥박지시련속심배혈량%급성호흡군박종합정%병사솔%혈관외폐수%액체관리
Pulse indicator continous cardica output%Acute respiratory distress syndrome%Mortality%Extravascular lung water%Fluid management
目的 研究脉搏指示连续心排血量(PiCCO)监测指导急性呼吸窘迫综合征(ARDS)患者液体管理的临床效果.方法 入选28例ARDS患者,随机分为干预组(n=15)和对照组(n=13),干预组在PiCCO监测下指导液体管理,对照组采用传统方法进行液体管理,治疗后统计两组患者一周内的血乳酸变化、氧合指数变化、机械通气时间、ICU住院时间及血管活性药物使用时间以及患者的28 d病死率,比较两组的差异.结果 两组患者一周内的血乳酸变化率差异无统计学意义(P=0.56),而干预组的氧合指数变化幅度明显较对照组大(140.0±26.4 vs 99.4±32.9,P=0.31),干预组患者机械通气时间明显短于对照组(21.8±3.5 vs 26.8±2.8,P=0.04),而ICU住院时间和血管活性药物使用时间的比较,差异无统计学意义.干预组患者的28 d病死率降低(60.0％ vs 69.2％),但差异无统计学意义(P＞0.05).结论 PiCCO监测指导ARDS患者液体管理可以改善患者的氧合,减少机械通气时间,但还不能显著降低患者的28 d病死率.
目的 研究脈搏指示連續心排血量(PiCCO)鑑測指導急性呼吸窘迫綜閤徵(ARDS)患者液體管理的臨床效果.方法 入選28例ARDS患者,隨機分為榦預組(n=15)和對照組(n=13),榦預組在PiCCO鑑測下指導液體管理,對照組採用傳統方法進行液體管理,治療後統計兩組患者一週內的血乳痠變化、氧閤指數變化、機械通氣時間、ICU住院時間及血管活性藥物使用時間以及患者的28 d病死率,比較兩組的差異.結果 兩組患者一週內的血乳痠變化率差異無統計學意義(P=0.56),而榦預組的氧閤指數變化幅度明顯較對照組大(140.0±26.4 vs 99.4±32.9,P=0.31),榦預組患者機械通氣時間明顯短于對照組(21.8±3.5 vs 26.8±2.8,P=0.04),而ICU住院時間和血管活性藥物使用時間的比較,差異無統計學意義.榦預組患者的28 d病死率降低(60.0％ vs 69.2％),但差異無統計學意義(P＞0.05).結論 PiCCO鑑測指導ARDS患者液體管理可以改善患者的氧閤,減少機械通氣時間,但還不能顯著降低患者的28 d病死率.
목적 연구맥박지시련속심배혈량(PiCCO)감측지도급성호흡군박종합정(ARDS)환자액체관리적림상효과.방법 입선28례ARDS환자,수궤분위간예조(n=15)화대조조(n=13),간예조재PiCCO감측하지도액체관리,대조조채용전통방법진행액체관리,치료후통계량조환자일주내적혈유산변화、양합지수변화、궤계통기시간、ICU주원시간급혈관활성약물사용시간이급환자적28 d병사솔,비교량조적차이.결과 량조환자일주내적혈유산변화솔차이무통계학의의(P=0.56),이간예조적양합지수변화폭도명현교대조조대(140.0±26.4 vs 99.4±32.9,P=0.31),간예조환자궤계통기시간명현단우대조조(21.8±3.5 vs 26.8±2.8,P=0.04),이ICU주원시간화혈관활성약물사용시간적비교,차이무통계학의의.간예조환자적28 d병사솔강저(60.0％ vs 69.2％),단차이무통계학의의(P＞0.05).결론 PiCCO감측지도ARDS환자액체관리가이개선환자적양합,감소궤계통기시간,단환불능현저강저환자적28 d병사솔.
Objective To study the impact on clinical outcomes of ARDS patients using PiCCO monitoring.Methods A total of 28 ARDS patients were randomly divided into intervention group (n =15) and control group (n =13),and the intervention group received PiCCO monitoring and the control group was not.The change of blood lactic acid and oxygenation index were measured in the first week using PiCCO.Patients were followed until time of hospital discharge to determine days of mechanical ventilation,ICU length of stay,days of vasoactive agent support and 28-day mortality.Results There were not significant differences between two groups in the change of blood lactic acid,but the change of oxygenation index was significantly increased in intervention group.Days of mechanical ventilation of intervention group was significantly shorter than the patients' of control group (21.8 ±3.5 vs 26.8± 2.8,P =0.04),however,there were not significant differences between two groups in ICU length of stay and days of vasoactive agent support.28-day mortality of intervention group was decreased compared to control group (60.0％ vs 69.2％),but the difference was not significant (P ＞0.05).Conclusions Fluid management using PiCCO system can significantly improve the oxygenation index and shorten duration of mechanical ventilation,but cann't significantly decrease the 28-day mortality rate of ARDS patients.
