现代医药卫生
現代醫藥衛生
현대의약위생
Journal of Modern Medicine & Health
2015年
17期
2588-2589,2593
,共3页
休克,脓毒性/治疗%多器官功能衰竭%危重病人医疗%复苏术%心排血量
休剋,膿毒性/治療%多器官功能衰竭%危重病人醫療%複囌術%心排血量
휴극,농독성/치료%다기관공능쇠갈%위중병인의료%복소술%심배혈량
Shock,septic/therapy%Multiple organ failure%Critical care%Resuscitation%Cardiac output
目的:探讨脉搏轮廓温度稀释连续心排血量(PICCO)监测技术在指导感染性休克液体复苏即早期目标导向治疗(EGDT)中的临床应用价值。方法选择2012年6月至2014年6月该院收治的感染性休克患者35例,根据是否采用PICCO监测技术分为对照组(15例)和治疗组(20例)。治疗组在PICCO监测技术指导下进行EGDT,对照组采用常规治疗及中心静脉压监测进行EGDT。观察两组患者达到EGDT所需时间,复苏后氧合指数[动脉血氧分压(PaO2)/吸入氧气分数(FiO2)]、乳酸、血糖及pH值。结果治疗组、对照组达到EGDT所需时间分别为(4.8±1.6)、(8.9±1.5)h,达EGDT目标时PaO2/FiO2分别为(366.7±45.6)、(310.9±45.3)mm Hg(1 mm Hg=0.133 kPa),乳酸分别为(4.8±1.2)、(5.7±1.3)mmol/L,血糖分别为(12.5±2.1)、(14.1±2.6)mmol/L,多脏器功能障碍综合征发生率分别为30.0%(6/20)、80.0%(12/15),病死率分别为35.0%(7/20)、66.7%(10/15),两组比较,差异均有统计学意义(P<0.05)。结论 PICCO监测技术容量性指标能准确、可靠地评估患者容量状态,对指导感染性休克患者进行EGDT具有重要价值。
目的:探討脈搏輪廓溫度稀釋連續心排血量(PICCO)鑑測技術在指導感染性休剋液體複囌即早期目標導嚮治療(EGDT)中的臨床應用價值。方法選擇2012年6月至2014年6月該院收治的感染性休剋患者35例,根據是否採用PICCO鑑測技術分為對照組(15例)和治療組(20例)。治療組在PICCO鑑測技術指導下進行EGDT,對照組採用常規治療及中心靜脈壓鑑測進行EGDT。觀察兩組患者達到EGDT所需時間,複囌後氧閤指數[動脈血氧分壓(PaO2)/吸入氧氣分數(FiO2)]、乳痠、血糖及pH值。結果治療組、對照組達到EGDT所需時間分彆為(4.8±1.6)、(8.9±1.5)h,達EGDT目標時PaO2/FiO2分彆為(366.7±45.6)、(310.9±45.3)mm Hg(1 mm Hg=0.133 kPa),乳痠分彆為(4.8±1.2)、(5.7±1.3)mmol/L,血糖分彆為(12.5±2.1)、(14.1±2.6)mmol/L,多髒器功能障礙綜閤徵髮生率分彆為30.0%(6/20)、80.0%(12/15),病死率分彆為35.0%(7/20)、66.7%(10/15),兩組比較,差異均有統計學意義(P<0.05)。結論 PICCO鑑測技術容量性指標能準確、可靠地評估患者容量狀態,對指導感染性休剋患者進行EGDT具有重要價值。
목적:탐토맥박륜곽온도희석련속심배혈량(PICCO)감측기술재지도감염성휴극액체복소즉조기목표도향치료(EGDT)중적림상응용개치。방법선택2012년6월지2014년6월해원수치적감염성휴극환자35례,근거시부채용PICCO감측기술분위대조조(15례)화치료조(20례)。치료조재PICCO감측기술지도하진행EGDT,대조조채용상규치료급중심정맥압감측진행EGDT。관찰량조환자체도EGDT소수시간,복소후양합지수[동맥혈양분압(PaO2)/흡입양기분수(FiO2)]、유산、혈당급pH치。결과치료조、대조조체도EGDT소수시간분별위(4.8±1.6)、(8.9±1.5)h,체EGDT목표시PaO2/FiO2분별위(366.7±45.6)、(310.9±45.3)mm Hg(1 mm Hg=0.133 kPa),유산분별위(4.8±1.2)、(5.7±1.3)mmol/L,혈당분별위(12.5±2.1)、(14.1±2.6)mmol/L,다장기공능장애종합정발생솔분별위30.0%(6/20)、80.0%(12/15),병사솔분별위35.0%(7/20)、66.7%(10/15),량조비교,차이균유통계학의의(P<0.05)。결론 PICCO감측기술용량성지표능준학、가고지평고환자용량상태,대지도감염성휴극환자진행EGDT구유중요개치。
Objective To explore the clinical application value of pulse-induced contour cardiac output (PICCO)moni toring technology in guiding the fluid resuscitation of infectious shock,i.e.,early goal-directed therapy(EGDT). Methods 35 cases of infectious shock in our hospital from June 2012 to June 2014 were selected and divided into the control group (15 cases) and the treatment group(20 cases). The treatment group was performed EGDT under the PICCO monitoring technology,while the control group adopted the conventional treatment and was conducted EGDT under central venous pressure (CVP) monitoring. The time for reaching EGDT,oxygenation index after resuscitation(PaO2/FiO2),lactic,glucose and PH values were observed in the two groups. Results The time for reaching EGDT in the treatment group and the control group was (4.8±1.6)h and(8.9±1.5)h respectively, PaO2/FiO2 for reaching the EGDT target was(366.7±45.6) mmHg and(310.9±45.3)mm Hg(1 mm Hg=0.133 kPa),lactic acid levels were (4.8±1.2) mmol/L and(5.7±1.3) mmol/L respectively,blood glucose levels were(12.5±2.1) mmol/L and(14.1±2.6) mmol/L respectively,and pH values were(7.2±0.3) and(7.1±0.2) respectively. The occurrence rates of multiple organ dysfunction syn-drome(MODS) in the treatment group and the control group were 30.0%(6/20) and 80.0%(12/15),the mortality rates were 35.0%(7/20)and 66.7%(10/15) respectively,the differences between the two groups were statistically significant (P<0.05). Conclusion The capacity indicators of PICCO monitoring technology can accurately and reliably assess the patient′s capacity status and have an important value to the guidance for conducting EGDT in the patients with infectious shock.