PICCO联合心脏超声对重症心肺损伤患者液体管理的临床价值

Clinical Value of PICCO Combined with Echocardiography in Fluid Management in Patients with Severe Cardiopulmonary Injury

目的:探讨脉搏指示性连续心排量监测(PICCO)联合心脏超声对重症心肺损伤患者液体管理的临床价值。方法:选择2018年5月至2021年7月我院收治的90例重症心肺损伤患者,采用随机数字表法分为观察组与对照组,各45例。对照组均参考中心静脉压(CVP)等常规指标进行血流动力学监测;观察组采用PICCO联合床旁心脏超声进行血流动力学监测。比较两组患者各项临床指标、心功能及预后情况。结果:治疗72h后,观察组CVP、肺超声评分、液体平衡均低于对照组(P<0.05);治疗72h后,观察组LVESD、LVEDD均低于对照组,LVEF水平高于对照组(P<0.05);观察组1个月内死亡率及肺部感染发生率均低于对照组(P<0.05);观察组机械通气时间及ICU住院时间均短于对照组(P<0.05)。结论:基于PICCO联合心脏超声监测数据制定的治疗方案有利于降低患者CVP,同时对患者肺损伤、心功能、体液平衡及预后结局的改善有重要价值,值得临床推广。

Objective:To investigate the clinical value of pulse indicator continuous cardiac displacement monitoring(PICCO)combined with cardiac ultrasound in fluid management of patients with severe cardiopulmonary injury.Methods:A total of 90 patients with severe cardiopulmonary injury admitted to our hospital from May 2018 to July 2021 were selected and divided into observation group and control group by random number table method,with 45 cases in each group.In the control group,hemodynamic monitoring was performed with reference to conventional indexes such as central venous pressure(CVP).The observation group used PICCO combined with bedside cardiac ultrasound for hemodynamic monitoring.Clinical indicators,cardiac function and prognosis were compared between the two groups.Results:After 72 hours of treatment,CVP,lung ultrasound score and fluid balance in the observation group were lower than those in the control group(P<0.05).After 72 hours of treatment,LVESD and LVEDD in the observation group were lower than those in the control group,and LVEF level was higher than that in the control group(P<0.05).The mortality and incidence of pulmonary infection in observation group were lower than those in control group(P<0.05).The duration of mechanical ventilation and ICU stay in the observation group were shorter than those in the control group(P<0.05).Conclusions:he treatment plan based on PICCO combined with cardiac ultrasound monitoring data is beneficial to reduce CVP in patients,and is of great value in improving lung injury,cardiac function,body fluid balance and prognosis,which is worthy of clinical promotion.