脉搏指示连续心排血量监测在脓毒性休克中的应用

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1、脉搏指示连续心排血量监测在脓毒性休克中的应用［摘要］目的探讨脉搏指示连续心排血量（PiCCO）监测在脓毒性休克的应用及护理效果。方法选择钦州市第一人民医院2013年6月〜2015年12月入住ICU治疗的符合脓毒性休克患者69例，由患者或家属自愿选择监测方式，分为观察组（PiCCO2监测组）33例和对照组（传统监测组）36例，记录两组患者入ICU治疗6h、3d后液体总入量、APACHEII评分及入ICU时与治疗3d后血浆氨基酸B型钠尿肽前体（NT-pro-BNP）和中心静脉压（CVP）前后差值水平及两组患者呼吸机支持时间、住ICU天

2、数、28d病死率等进行比较和分析。结果观察组治疗3d后APACHEII评分低于对照组，呼吸机支持时间及住ICU天数短于对照组，入ICU3d前后NT-pro-BNP变化差值（△NT-pro-BNP）大于对照组、入ICU3d前后CVP变化差值（ACVP）的变化值小于对照组，差异有统计学意义（均P0.05）。结论PiCCO2监测结合早期目标导向性治疗（EGDT）可有效指导容量复苏和后续治疗，缩短感染性休克患者呼吸机支持时间及住ICU时间，有利于改善脓毒性休克患者的危重度。［关键词］PiCCO2监测b脓毒性休克；护理［中图分类号］R364

3、.1［文献标识码］A［文章编号］1674-4721(2016)08(a)-0172-04［Abstract］ObjectiveToinvestigatetheapplicationeffectofpluseindicatorcontinuouscardiacoutput(PiCCO)monitoringandnursingcareofpatientswithsepticshock.MethodsAccordingtovoluntarychoicebypatientsortheirfamiliesmonitoring，69cases

4、withsepticshockpatientsadmittedintoICUofQinzhouCityFirstPeople’sHospitalfromJune2013toDecember2015wereselectedanddividedintoobservationgroup(PiCCO2monitoringgroup)33casesand36casesofcontrolgroup(traditionalmonitoringgroup)，twogroupsofpatientsinICUtreatmentfor6h，3daysa

5、ftertheliquidinquantity，APACHEIIscorewererecorded，andadmissiontotheICUaminoacidsinbloodplasmaBtypenatriureticpeptideprecursor(NT-Pro-BNP)andcentralvenouspressure(CVP)differencebetweenbeforeandafterthelevelwerealsorecorded，treatmentinpatientswithventilatorsupporttime,l

6、iveICUdays，28daymortalityratewereobserved，andthosewerecomparedandanalyzedintwogroups.ResultsPatientsintheobservationgroupweretreated3daysaftertheAPACHEIIscorewaslowerthanthatofthecontrolgroup，thedurationofventilatorsupportandliveICUdaysshorterthanthoseofcontrolgroup,i

7、ntoICU3daysbeforeandaftertheNTProBNPdifference(△NT-Pro-BNP)isgreaterthanthatofcontrolgroup，thechangesofCVPdifference(ACVP)valuewaslessthanthecontrolgroup,thedifferencehadstatisticalsignificance(allP0.05)inthetotalamountofliquidinICU6hor3daysand28daymortalityrate.Concl

8、usionPiCCO2monitoringcombinedwithearlygoaldirectedtherapy(EGDT)caneffectivelyguidecapacityrecoveryandsubsequenttreatment，sho