PICCO在重型颅脑损伤并失血性休克患者救治中的应用

PICCO for patients with severe brain injury complicated with hemorrhagic shock

目的 研究PICCO（脉搏轮廓温度稀释连续心排量）指导重型颅脑损伤并失血性休克的治疗效果.方法 将48例重型颅脑损伤并失血性休克患者随机分为治疗组和对照组,各24例.对照组使用神经科常规治疗或外科手术治疗,监测CVP指导补液.治疗组应用PICCO监测血流动力学指标进行液体管理.对两组患者液体复苏效果、GCS评分、撤机时间、外伤性脑梗死发生率以及死亡率进行比较.结果 治疗1周后,治疗组失血性休克纠正优于对照组,GCS评分高于对照组,撤机时间早于对照组,外伤性脑梗死发生率、死亡率低于对照组,两组比较,差异均有统计学意义（P＜0.05）.结论 PICCO监测能提高重型颅脑损伤并失血性休克患者抢救成功率,改善预后.

Objective To study the clinical significance of PICCO for patients with severe brain injury complicated with hemorrhagic shock.Methods 48 patients with severe brain injury complicated with hemorrhagic shock were randomly divided into a treatment group and a control group.The control group took routine neurological treatment or surgical treatment and were infused fluid monitoring center venous pressure （CVP）.PICCO was used in the treatment group.The effect of fluid resuscitation,GCS score,time to demachine,incidence of traumatic cerebral infarction,and mortality were compared between the 2 groups.Results One week after the treatment,the treatment group recovered better from hemorrhagic shock than the control group;GCS score was higher in the treatment group than in the control group; the treatment group de-machined earlier than the control group; the incidence of traumatic cerebral infarction and mortality were lower in the treatment group than in the control group; with statistical differences （P 〈 0.05）.Conclusions PICCO for patients with severe brain injury complicated with hemorrhagic shock can decrease the mortality and improve the prognosis.