脉搏指数连续心输出量(PiCCO)监测在感染性休克患者早期液体复苏中的应用及护理

Shunling Li, S. Liang, Weihua Xue
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摘要

背景:感染性休克是一种瞬息万变的致死性综合征,可引起心肺、肾功能全面恶化和多器官功能衰竭。同时,感染性休克具有复杂的临床表现和血流动力学。PiCCO能准确监测血流、生理及容积指标,积极有效的液体复苏是降低脓毒性休克病死率、改善患者预后的重要措施。目的:探讨PiCCO在感染性休克患者早期液体复苏中的应用及护理。方法:回顾性观察性研究。观察组和对照组各30例。观察组采用PiCCO指导液体复苏;对照组采用常规方法指导液体复苏。观察两组患者CVP、HR、MAP、每小时尿量的变化。比较两组患者液体复苏前后各项指标变化、ICU住院时间及死亡率。所有结果均收集自患者出院后的电子病例系统。结果:观察组与对照组APACHEⅱ、CVP、HR、MAP比较,差异均有统计学意义(P < 0.05)。观察组患者补液后血容量明显改善(P < 0.05)。与对照组比较,观察组患者在ICU的住院时间明显缩短,病死率也明显降低(P < 0.05)。结论:PiCCO可较好地用于感染性休克患者的早期液体复苏。
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Application and Nursing of Pulse Index Continuous Cardiac Output (PiCCO) Volume Monitoring in Early Fluid Resuscitation in Patients with Septic Shock
Background: Septic shock is a rapidly changing and fatal syndrome that can cause comprehensive deterioration of cardiopulmonary and renal function and multiple organ failure. At the same time, septic shock has the complex clinical manifestations and hemodynamics. PiCCO can accurately monitor blood flow, physical and volume indicators, and active and effective fluid resuscitation are important measures to reduce the fatality rate of septic shock and improve the prognosis of patients. Objectives: To explore the application and nursing of PiCCO in early fluid resuscitation in patients with septic shock. Methods: This was a retrospective observational study. The observation group and the control group each had 30 cases. The observation group used PiCCO to guide fluid resuscitation; the control group used conventional methods to guide fluid resuscitation. The changes in CVP, HR, MAP, and urine volume per hour were observed in the two groups. The changes of various indicators before and after fluid resuscitation, the length of stay in ICU and the mortality rate were compared between the two groups. All the outcomes were collected from the electronic medical case system after patients’ discharge from the hospital. Results: APACHE II, CVP, HR, MAP were compared between the observation group and the control group, and the differences were statistically significant (P 0.05). The blood volume of patients in the observation group was significantly improved after fluid supplementation (P 0.05). Compared with the control group, the length of stay in ICU in the observation group was significantly shorter, and the mortality rate was also significantly reduced (P 0.05). Conclusion: PiCCO can be better used in early fluid resuscitation of patients with septic shock.
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