NICaS在老年腹部术后机械通气患者中的应用

The Application of NICaS to Elderly Patients with Postoperative Abdominal Mechanical Ventilation

目的研究阻抗心输出量测量系统(noninvasive cardiac output monitoring system,NICaS)在老年腹部术后机械通气患者中的应用。方法将入选的60例老年腹部手术后机械通气患者随机分为两组,其中对照组采用传统补液原则进行补液,试验组采用NICaS监测进行补液,记录两组患者术后24 h心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、呼吸频率(respiratory rate,RR)、氧合指数、液体入量、尿量、呋塞米用量、机械通气时间及重症监护病房(intensive care unit,ICU)住院时间并进行统计分析。结果两组患者术后24 h HR、MAP、RR比较无明显变化,差异无统计学意义(P>0.05)试验组的氧合指数、24 h尿量、呋塞米用量高于对照组,差异有统计学意义(P<0.05);试验组的24 h液体入量、机械通气时间及ICU住院时间明显低于对照组,差异有统计学意义(P<0.05)。结论老年腹部术后机械通气患者应用NICaS监测能够改善氧合指数,减少机械通气时间,缩短ICU住院时间。

Objective To discuss the application of noninvasive cardiac output monitoring system(NICaS)on elderly patients with postoperative abdominal mechanical ventilation.Methods 60 cases of elderly patients with mechanical ventilation after abdominal surgery were randomly divided into two groups.The control group adopted traditional rehydration principle,while NICaS monitoring was used in the experimental group.The heart rate(HR),mean arterial pressure(MAP),respiratory rate(RR),oxygenation index,fluid intake,urine output,furosemide dosage,mechanical ventilation time and ICU length of hospital stay of both groups at 24 h after surgery were recorded and statistical analysis was carried out.Results There was no significant change in 24 h postoperative HR,MAP and RR between the two groups(P>0.05).The oxygenation index,24 h urine output and furosemide dosage of the experimental were higher than those in the control group,with statistically significant difference(P<0.05).The 24 h fluid intake,mechanical ventilation time and ICU hospitalization time in the experimental group were significantly lower than those in the control group.The difference was statistically significant(P<0.05).Conclusion The application of NICaS monitoring in elderly patients with mechanical ventilation after abdominal surgery can improve oxygenation index,reduce the duration of mechanical ventilation,and shorten the length of ICU stay.