PiCCO技术对复杂先天性心脏病患儿围手术期治疗的意义

Application of pulse-indicated continuous cardiac output system in perioperative children with complex congenital heart disease

目的:探讨脉搏指数连续心排出量(pulse indicated continuous cardiac output,PiCCO)监测在复杂性先天性心脏病患儿围术期治疗的指导意义。方法:选取复杂性先天性心脏病矫治术后的患儿104例,随机分为两组,PiCCO组(51例),均放置PiCCO导管监测平均动脉压(MAP)、心输出量(CO)、连续心输出量(CCO)、外周血管阻力(SVR)、胸腔内血容量(ITBV)、全心舒张末期容量(GEDV)、血管外肺水(EVLW)等,并指导临床治疗。对照组(53例),不放置PiCCO导管,凭经验及其他常规指标指导治疗。结果:PiCCO组机械通气时间、ICU滞留时间、血管活性药物使用时间显著短于对照组,但两组患儿左室射血分数(LVEF)、脑钠尿肽(BNP)、胸片渗出情况、感染率、病死率均无统计学差异。结论:PiCCO技术在复杂性先天性心脏病患儿术后治疗中有一定的实用价值。

AIM： To evaluate the application of pulse-indicated continuous cardiac output （PiCCO） system in perioperative children with complex congenital heart disease. METHODS： One hundred and four children with complex congenital heart disease were randomly divided into two groups. MAP, CO, CCO, SVR, ITBV, GEDV, and EVLW were measured after surgery in Group A （n = 51 ） , whereas patients in Group B （n = 53 ） were treated by experience and other indexes without application of PiCCO. RESULTS： The time of mechanical ventilation, ICU stay and administration of positive inotropic drugs in Group A were significantly shorter than in Group B. No statistical differences were observed in LVEF, BNP, pleural effusion, rate of infections and mortality between groups. CONCLUSION ： The application of PiCCO is beneficial in the treatment of perioperative children with complex congenital heart disease.