摘要
目的:探讨脉搏指数连续心输出量监测(Pulse index continuous cardiac output,PICCO)在维持亚低温治疗重度颅脑损伤患者血流动力学稳定性临床效果。方法:回顾分析2012年1月至2015年9月入住ICU的重型颅脑损伤行亚低温治疗患者(≥18岁)选取90例,分为对照组和PICCO组,PICCO组通过PICCO监测仪实时监测患者血流动力学,依靠数据参数来维持稳定血流动力学,对照组仅用常规循环监测指标使血流动力学稳定。结果:在亚低温治疗时血流动力学改变主要在降温期和低温期发生,PICCO组低血压发生率低于对照组(P<0.05)。PICCO组神经源性肺水肿发生率低于对照组(P<0.05),PICCO组患者液体入量比对照组少(P<0.05),PICCO组ICU住院时间短于对照组(P<0.01),PICCO组GCS评分高于对照组(P<0.01)。结论:在严重颅脑损伤亚低温治疗中,PICCO可实时监测血流动力学参数,合理的管理液体出入量及指导镇定药物的剂量,可以使血流动力学更加稳定,有效控制亚低温治疗中低血压、心律失常及神经源性肺水肿的发生,降低并发症发生率,提高患者生存率,改善预后。
Objective： To study the clinical effect of Pulse index continuous cardiac output monitoring （PICCO） in maintaining he- modynamic stability of mild hypothermia therapy in severe craniocerebral injury patients. Methods： To select 90 patients （aged equal to or more than 18 years old） with severe craniocerebral injury who received mild hypothermia therapy in intensive care unit （ICU） from Jan 2012 to Sep 2015 for retrospective analysis, divided into control group and the PICCO group.PICCO group depended on the data parameter of PIC- CO monitor real-time monitoring to maintain stable hemodynamics, and control group depended on the regular circulation monitoring indica- tors.Results： The hemodynamic changes in cooling and low temperature, the incidence of hypotension in PICCO group were lower than that in the control group （P〈0.05）. The incidence of neurogenic pulmonary edema in the PICCO group was lower than that in the control group （P〈 0.05）, patients＇ liquid intake in the PICCO group was less than that in the control group （P〈0.05）, hospitalization time in ICU of the PICCO group was shorter than that in the control group （P〈0.01）, GCS score in the PICCO group was higher than that in the control group （P〈0.01）. Conclusion： As for patients with severe eraniocerebral injury received miht hypothermia therapy, PICCO can be real-time monitoring of he- modynamic parameters, reasonable management of liquid intake and guide the calm drug dose, which can make the hemodynamic stability, effective control of the cryogenic treatment of low blood pressure, cardiac arrhythmia, and complications of neurogenic pulmonary edema, re- duce the incidence of complications and improve the patients survival rate and prognosis.
出处
《甘肃医药》
2016年第2期84-86,共3页
Gansu Medical Journal
