脉波指示剂连续性心排血量监测在脓毒性休克早期液体复苏治疗中的应用对改善患者氧代谢异常的意义分析

PiCCO Monitoring in Early Fluid Resuscitation of Septic Shock in Improving Abnormal Oxygen Metabolism of Patients

目的:分析脉波指示剂连续性心排血量(pulse indicator continous cardiac output,PiCCO)监测在脓毒性休克早期液体复苏治疗中的应用对改善患者氧代谢异常的意义。方法:选取2018年5月-2020年5月本院收治的脓毒性休克患者72例,以双盲随机抽样法分为参照组和试验组,各36例。参照组采纳中心静脉压(CVP)指导液体复苏治疗,试验组采纳PiCCO指导液体复苏治疗。对比两组APACHEⅡ评分、每小时尿量、CVP、MAP、复苏液体量、乳酸清除率、并发症发生率、呼吸机使用率。结果:治疗24 h后,试验组APACHEⅡ评分比参照组低,每小时尿量、CVP、MAP、复苏液体量、乳酸清除率均比参照组高,并发症发生率、呼吸机使用率均比参照组低,差异均有统计学意义(P<0.05)。结论:PiCCO指导液体复苏治疗可有效改善脓毒性休克患者病情,增加尿量,提高乳酸清除率,降低并发症发生率及呼吸机使用率,值得借鉴。

Objective:To analyze the significance of pulse indicator continous cardiac output(PiCCO)monitoring in early fluid resuscitation of septic shock in improving abnormal oxygen metabolism.Method:A total of 72 patients with septic shock admitted to our hospital from May 2018 to May 2020 were selected,they were divided into the reference group and the experimental group,by double-blind random sampling,36 cases in each group.The reference group was guided by central venous pressure(CVP)for fluid resuscitation treatment,the experimental group adopted PiCCO to guide fluid resuscitation treatment.The APACHEⅡscore,hourly urine output,CVP,MAP,resuscitation fluid volume,lactic acid clearance rate,complication rate,and ventilator utilization rate were compared between two groups.Result:After 24 h of treatment,the APACHEⅡscore of the experimental group was lower than that of the reference group,the hourly urine volume,CVP,MAP,resuscitation fluid volume,lactic acid clearance rate were all higher than those of the reference group,the incidence of complications and ventilator utilization were all lower than those of the reference group,with statistically significant differences(P<0.05).Conclusion:PiCCO guiding fluid resuscitation therapy can effectively improve the condition of septic shock patients,increase urine volume and increase lactic acid clearance rate,reduce the incidence of complications and ventilator utilization rate,worthy of reference.