PiCCO监测在脓毒性休克患者中的应用分析

摘要

Objective Our retrospective study was aimed toanalyze the difference of efficiency of PiCCO and traditional monitor.Meth-ods Clinical data of patients with septic shockreceived treatment at our hospitalfrom 2011 to 2013 was retrospectivelyanalyzed.Theywere divided into PiCCO group (consist of A,B and C according to the value of EVLWI)and tradition group due to the different moni-tor ways.Results A total of 120 patients were retrospective analyzed.The PiCCO grouphadsuperiority over the tradition group in thespeed of retrieval of CVP and MAP,the decline rate and the efficacy.Conclusion The PiCCO group had superiority over the traditiongroup in the speed of retrieval of CVP and MAP,the decline rate and the efficacy.%目的：比较PiCCO（脉搏指示连续心输出量测定）监测与传统监测在脓毒性休克患者中的应用疗效及PiCCO监测的EVLWI值与治疗疗效相关性。方法分析2011年1月至2013年1月在该院监护病房接受治疗的脓毒性休克患者的临床资料；根据监测方法分为PiCCO监测组和常规监测组。并对PiCCO组患者根据入组时EVLWI值分为A组（EVLWI值≤7），B组（EVLWI值为7～12）和C组（EVLWI值≥12）三组，观察三组患者的预后。结果入组患者120例，其中PiCCO组56例，常规组64例，A组26例，B组16例，C 组14例。PiCCO组和常规组入组时、72 h时的CVP、MAP值均无统计学差异（P均＞0．05），而24h时两组CVP值和MAP值均有明显的差异（P均＜0．05）；一周后PiCCO组患者的CRP（t＝2．078，P＝0．036）、IL-6（t＝2．450，P＝0．016）和PCT（t＝5．324，P＜0．01）水平低于常规组；PiCCO组预后（一周时）优于常规组（χ2＝4．627，P＝0．031）；A、B、C三组患者治疗有效率差异有着统计学意义（χ2＝6．087，P＝0．048），EVLWI值越小，预后愈佳。结论 PiCCO组患者的CVP、MAP值恢复正常的速度、炎症指标下降速度和治疗有效率均优于常规组，且PiCCO组EVLWI值与最终治疗有效率有着明显的相关性，EVLWI值越小，预后愈佳。