picco指导的crrt液体管理对感染性休克患者预后的影响

The Influence of Picco Guidance of CRRT Liquid Management for the Prognosis of Patients with Septic Shock

目的:探讨感染性休克患者CRRT持续肾脏替代治疗中以PICCO指导液体管理对患者临床预后的作用。方法:选取2013至2016年我院收治的感染性休克患者,随机平均分为两组,分别在CRRT治疗中选择常规液体管理方式与PICOO指导液体管理。结果:患者复苏后6h乳酸<2mmo L/L以及Scv O2≥70%比例差异无统计学意义(P>0.05),观察组患者48h复苏液体用量、去甲肾上腺素用量少于对照组,差异具有统计学意义(P<0.05),呼吸机时间少于对照组,差异具有统计学意义(P<0.05),肺水肿发生率与28d内死亡率低于对照组,差异具有统计学意义(P<0.05)。结论:PICCO指导感染性休克患者液体管理,可以提供患者血流动力学量化监测指标,有利于患者CRRT治疗的预后,减少药物及液体用量。

Objective： To observe the function of patients with septic shock CRRT continuous renal replacement therapy in PICCO liquid management of patients with clinical prognosis. Methods： All the septic shock patients admitted in our hospital from 2013 to 2016 were averaged randomly divided into two groups,respectively in the CRRT treatment choice conventional liquid PICOO management style and management. Results： The level of lactic acid was below 2mmo L / L and the level of Scv O2≥70% on 6 hours after recovery.There was no significant difference（ P 〉 0.05）. The liquid dosage,the dosage of phenylephrine of patients after 48 hours recovery of the observation group were significantly less than the control group（ P 〈 0.05）,and the time of breathing machine was less than the control group（ P 〈0.05）; the incidence of pulmonary edema within 28 days and mortality was significantly lower than the control group（ P 〈 0.05）. Conclusion： PICCO guidance of patients with septic shock fluid management can provide hemodynamic quantitative monitoring indicators for patients,and make for outcomes with CRRT treatment for patients,reduce drug dosage and liquid.