摘要
目的观察脉波轮廓温度稀释连续心排监测技术(PICCO)在重症感染患者连续性肾脏替代治疗(CRRT)容量管理中的应用效果及价值。方法随机选取2014年1月~2019年6月我院接收的30例行连续性肾脏替代治疗的重症感染患者,采用随机数字表法,分为观察组与对照组,各15例,实施不同的监测方法,对照组应用经动脉波形分析技术,观察组应用PICCO监测技术。结果两组患者治疗前、治疗后的血流动力学参数指标无统计意义(P>0.05);2组患者组内治疗后与治疗前的血流动力学参数指标对比差异显著(P<0.05)。观察组与对照组患者治疗前乳酸[(9.54±0.57)mmol/L比(9.36±0.29)mmol/L]、碱剩余[(14.27±1.56)mmol/L比(14.38±1.75)mmol/L]比较,差异均无统计意义(均P>0.05)。治疗后观察组乳酸[(3.54±0.28)mmol/L比(6.87±0.67)mmol/L]、碱剩余[(5.13±0.64)mmol/L比(10.26±0.95)mmol/L]比较,差异均有统计意义(均P<0.05)。两组患者观察组康复12(80.00%),对照组3(20.00%)比较差异有统计学意义(P<0.05)。结论PICCO与经动脉波形分析技术均可提高重症感染患者连续性肾脏替代治疗容量管理中的监测水平,对连续性肾脏治疗起到监测性作用。但PICCO的血流动力学参数指标监测范围更加全面,能够掌握患者治疗期间心脏舒张和收缩情况,因此临床应用效果更显著,可在临床中推广应用。
Objective To observe the effect and value of pulse contour temperature-diluted continuous cardiac monitoring(PICCO)in the management of continuous renal replacement therapy(CRRT)in patients with severe infection.Methods Thirty patients with severe infection who underwent continuous renal replacement therapy received from our hospital from January 2014 to June 2019 were randomly selected.The randomized digital table method was used to divide the observation group and the control group into 15 cases.Monitoring methods,the control group used transarterial waveform analysis technology,and the observation group applied PICCO monitoring technology.Results There were no statistically significant differences in hemodynamic parameters between the two groups before and after treatment(P>0.05).There was significant difference between the two groups in the treatment group and the hemodynamic parameters before treatment(P<0.05).Lactic acid[(9.54±0.57)mmol/L ratio(9.36±0.29)mmol/L]and alkali residual[(14.27±1.56)mmol/L ratio(14.38±1.75)mmol/L in the observation group and the control group]In comparison,the differences were not statistically significant(all P>0.05).After treatment,the observation group managed lactic acid[(3.54±0.28)mmol/L ratio(6.87±0.67)mmol/L],and the alkali residual[(5.13±0.64)mmol/L ratio(10.26±0.95)mmol/L],the difference All were statistically significant(all P<0.05).After treatment,the two groups of patients underwent rehabilitation in the observation group(120.00%),and in the control group(20.00%),the difference was statistically significant(P<0.05).Conclusion Both PICCO and transcatheter waveform analysis can improve the monitoring of continuous renal replacement therapy in patients with severe infection,and play a monitoring role in continuous renal therapy.However,the monitoring range of PICCO’s hemodynamic parameters is more comprehensive,and it can grasp the diastolic and contraction of the patient during treatment.Therefore,the clinical application effect is more significant and can be promoted and applied in the clinic.
作者
王小红
WANG Xiao-hong(Intensive Care Unit,Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Changzhou 213000,China)
出处
《中国误诊学杂志》
CAS
2019年第6期245-248,共4页
Chinese Journal of Misdiagnostics
