PICCO在顽固性心力衰竭患者血流动力学监测中的临床价值

Clinical Value of PICCO in Hemodynamic Monitoring on Patients with Refractory Heart Failure

目的探讨脉搏指示连续心!排量监测(pulse indicator continuous cardiac output monitoring,PICCO)下顽固性心力衰竭患者的血流动力学特征,为其临床治疗提供参考。方法选取我院2013年8月至2014年7月收治住院治疗的顽固性心力衰竭患者56例的临床资料,分为行PICCO组和常规组。比较分析两组治疗后血流动力学特征参数血管外肺水指数(EVLWI)、全心舒张末期容积(GEDVI)、胸腔内血容积指数(ITBVI)及心脏功能指数(CFI)和左心室射血分数(LVEF)、机械通气时间、ICU监护时间、APACHE-II评分及再次住院率等指标。结果 PICCO组患者心血流动力学特征参数均优于常规组,两组比较差异有统计学意义(P<0.05)。PICCO组机械通气时间、ICU监护时间、APACHE-II评分及再次住院率均优于常规组,两组比较差异有统计学意义(P<0.05)。结论 PICCO指导顽固性心力衰竭的临床治疗具有较高的应用价值。

Objective To investigate the clinical value of pulse indicator continuous cardiac output （PICCO） in monitoring hemo- dynamic characteristics on patients with refractory heart failure, so as to provide reference for its clinical treatment. Methods 56 ca- ses of patients with refractory heart failure in our hospital from August 2013 to July 2014 were chosen and divided into PICCO group and routine group. The two groups were compared in terms of hemodynamic characteristic parameters of extravascular lung water index （EVLWI）, global end diastolic volume index （GEDVI）, intrathoracic blood volume index （ITBVI）, heart function index （CFI）, left ventricular ejection fraction （LVEF） , mechanical ventilation time, ICU monitoring time, APACHE -II score and the re -hospitaliza- tion rate. Results Blood flow dynamics characteristic parameters in PICCO group were better than those of the control group. The difference between the two groups was statistically significant （ P 〈 0. 05 ）. In PICCO group, duration of mechanical w^ntilation, ICU monitoring time, APACHE - II score and re - hospitalization rate were superior to those of the control group. The difference between the two groups was statistically significant （P 〈 0. 05 ）. Conclusion PICCO has the high application value in guiding clinical treat- ment of refractory heart failure.