中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2014年
28期
43-45
,共3页
感染休克%早期液体复苏%PiCCO监测%炎症因子
感染休剋%早期液體複囌%PiCCO鑑測%炎癥因子
감염휴극%조기액체복소%PiCCO감측%염증인자
Infection shock%Early fluid resuscitation%PiCCO monitoring%Inflammatory cytokine
目的：探讨PiCCO监测在感染休克早期液体复苏中的应用效果。方法90例感染休克患者根据随机数字表法分为治疗组与对照组，各45例，治疗组采用PiCCO监测仪记录胸腔内血容积指数(ITBVI)、心脏指数(CI)、外周血管阻力指数(SVRI)、血管外肺水指数(EVLWI)，依据PiCCO血流动力学数据分型对患者进行个体化治疗及疗效评估；对照组采用常规液体复苏治疗和疗效评估。观察并记录治疗组治疗前和治疗后30 min、2 h、4 h及12 h的ITBVI、CI、SVRI、EVLWI，并记录两组治疗前和治疗后24 h乳酸水平、中心静脉血氧饱和度(ScvO2)、排尿量及死亡率。结果治疗组治疗后30 min、2 h、4 h及12 h的ITBVI、CI及EVLWI高于治疗前，治疗后12 h的SVRI高于治疗前，差异有统计学意义(P<0.05)。治疗后24 h，两组ScvO2、乳酸水平、排尿量较治疗前均有改善，差异有统计学意义(P<0.05)；观察组治疗后24 h的ScvO2、乳酸水平、排尿量较对照组改善明显，差异有统计学意义(P<0.05)。两组死亡率对比差异有统计学意义(P<0.05)。结论 PiCCO监测应用于感染休克早期液体复苏能快速有效地改善机体组织灌注，有重要的临床指导意义。
目的：探討PiCCO鑑測在感染休剋早期液體複囌中的應用效果。方法90例感染休剋患者根據隨機數字錶法分為治療組與對照組，各45例，治療組採用PiCCO鑑測儀記錄胸腔內血容積指數(ITBVI)、心髒指數(CI)、外週血管阻力指數(SVRI)、血管外肺水指數(EVLWI)，依據PiCCO血流動力學數據分型對患者進行箇體化治療及療效評估；對照組採用常規液體複囌治療和療效評估。觀察併記錄治療組治療前和治療後30 min、2 h、4 h及12 h的ITBVI、CI、SVRI、EVLWI，併記錄兩組治療前和治療後24 h乳痠水平、中心靜脈血氧飽和度(ScvO2)、排尿量及死亡率。結果治療組治療後30 min、2 h、4 h及12 h的ITBVI、CI及EVLWI高于治療前，治療後12 h的SVRI高于治療前，差異有統計學意義(P<0.05)。治療後24 h，兩組ScvO2、乳痠水平、排尿量較治療前均有改善，差異有統計學意義(P<0.05)；觀察組治療後24 h的ScvO2、乳痠水平、排尿量較對照組改善明顯，差異有統計學意義(P<0.05)。兩組死亡率對比差異有統計學意義(P<0.05)。結論 PiCCO鑑測應用于感染休剋早期液體複囌能快速有效地改善機體組織灌註，有重要的臨床指導意義。
목적：탐토PiCCO감측재감염휴극조기액체복소중적응용효과。방법90례감염휴극환자근거수궤수자표법분위치료조여대조조，각45례，치료조채용PiCCO감측의기록흉강내혈용적지수(ITBVI)、심장지수(CI)、외주혈관조력지수(SVRI)、혈관외폐수지수(EVLWI)，의거PiCCO혈류동역학수거분형대환자진행개체화치료급료효평고；대조조채용상규액체복소치료화료효평고。관찰병기록치료조치료전화치료후30 min、2 h、4 h급12 h적ITBVI、CI、SVRI、EVLWI，병기록량조치료전화치료후24 h유산수평、중심정맥혈양포화도(ScvO2)、배뇨량급사망솔。결과치료조치료후30 min、2 h、4 h급12 h적ITBVI、CI급EVLWI고우치료전，치료후12 h적SVRI고우치료전，차이유통계학의의(P<0.05)。치료후24 h，량조ScvO2、유산수평、배뇨량교치료전균유개선，차이유통계학의의(P<0.05)；관찰조치료후24 h적ScvO2、유산수평、배뇨량교대조조개선명현，차이유통계학의의(P<0.05)。량조사망솔대비차이유통계학의의(P<0.05)。결론 PiCCO감측응용우감염휴극조기액체복소능쾌속유효지개선궤체조직관주，유중요적림상지도의의。
Objective To investigate the application effects of PiCCO monitoring in the fluid resuscitation of early in-fection shock. Methods Ninety patients with infection shock were divided into treatment group and control group ac-cording to the random number table method,with 45 patients in each group.PiCCO monitor was used to record the in-trathoracic blood volume index(ITBVI),cardiac index(CI),systemic vascular resistance index(SVRI)and extravascular lung water index(EVLWI),and the patients were given personalized treatment and efficacy evaluation according to the PiCCO hemodynamic data type in treatment group.The conventional fluid resuscitation treatment and efficacy evaluation were used in control group.Before treatment and after treatment of 30-minute,2-hour,4-hour and 12-hour,ITBVI,CI,SVRI and EVLWI of treatment group was observed and recorded respectively,and before treatment and after treatment of 24-hour,lactate level,central venous oxygen saturation,urine output and mortality rate of both groups was recorded respec-tively. Results After treatment of 30-minute,2-hour,4-hour and 12-hour,ITBVI,CI,SVRI and EVLWI of treatment group was higher than that before treatment respectively,SVRI of treatment group after treatment of 12-hour was higher than that before treatment,with statistical difference (P<0.05).After treatment of 24-hour,improvement of lactate level, central venous oxygen saturation and urine output in both groups was better than that before treatment respectively,with statistical difference (P<0.05).After treatment of 24-hour,improvement of lactate level,central venous oxygen saturation and urine output in treatment group was significantly better than that in control group respectively,with statistical differ-ence(P<0.05).The two groups had statistical difference in mortality rate(P<0.05). Conclusion PiCCO monitoring applied in the fluid resuscitation of early infection shock can improve the body’s tissue perfusion rapidly and effectively and has important clinical significance.
