简体中文

·胸部疾病·

PiCCO监测在危重病患诊治应用前景分析

作者:刘建凌 陈 军 温振杰

所属单位:广东省清远市人民医院 (广东 清远 511500)

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摘要

目的 探讨PiCCO监测在危重病患者诊疗中的应用价值,分析其应用前景。方法 收集200例危重患者,入院后同时 给于PAC及PiCCO监测,观察检测开始后1min、12h、1d三个时间点的检测数据,数据包括心率(HR)、平均动脉压 (MAP)、心排血量(CO)、中心静脉压(CVP)、胸腔内血容量指数(ITBVI)、血管外肺水指数(EVLWI),并进行对比分 析。结果 患者六项指标分别经球形检验发现,P>0.05,符合球形分布,采用重复测量方差分析后续结果。结果显 示,患者六项指标不同时间点差异显著(P<0.05),但组别与时间交互项均无差异(P>0.05)。说明患者患者六项指标 两种检测方式不同时间点存在明显差异,但个时间点两种检测方式比较,无差异。结论 两种检测方式所得血流动 力学相似,但PiCCO可进一步测量 ITBVI、EVLWI,对判断液体及血管容量影响较大,对危重患者而言具有较大的应 用价值,具有进一步推广及研究的前景。

Objective to investigate the application value of PiCCO monitoring in the diagnosis and treatment of critically ill patients, and to analyze its application prospects. Methods 200 cases of critically ill patients, after admission to the PAC and PiCCO, starting test after three time of 1min, 12h, 1D detection data observation data including heart rate (HR), mean arterial pressure (map), cardiac output (CO), central venous pressure (CVP), thoracic cavity blood volume index (ITBVI), extravascular lung water index (EVLWI), and carries on the contrast analysis. Results the six indexes of the patients were found by sphere test, P>0.05, in accordance with the spherical distribution, and the follow-up results were analyzed by repeated measures analysis of variance. The results showed that there were significant differences in the six indicators (P<0.05) at different time points, but there was no difference between the group and the time of the group (P>0.05). Six indicators of patients with two indicators of different time points, there are significant differences, but the two time points of comparison, there is no difference. Conclusion the two kinds of detection of similar income hemodynamics, but PiCCO can further measurements ITBVI and EVLWI and impact to judge the liquid and blood capacity and larger for critically ill patients with great application value, with the prospect of further promotion and research.

【关键词】脉搏轮廓心排血量;肺动脉漂浮导管;血流动力学

【中图分类号】R542.5+4

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.02.008

前言

危重患者诊治过程中,对其进行血流动力学监 测可帮助医师判断患者病情转归。目前常用的为有 创监测方式[1],脉搏轮廓心排血量(pulse contour cardiac output,PiCCO)即为血流动力学监测中较 为新颖的一种[2]。本次研究通过对比同一危重病患 者PiCCO与肺动脉漂浮导管监测(PAC)的差异,探讨 PiCCO在危重病患者中诊治的应用价值,分析PiCCO在 此类患者中应用的前景,现将结果报道如下。