PICCO BCT参数对脓毒性休克患者短期预后的预测价值

Predictive Value of PICCO BCT Parameters on Short-term Prognosis of Patients with Septic Shock

目的:探讨PICCO BCT参数对脓毒性休克患者短期预后的预测价值。方法:选取2021年1月-2022年8月茂名市人民医院重症医学科收治的脓毒性休克患者47例为观察对象,根据患者Td存活情况分为存活组(n=26)与死亡组(n=21)。指标测量,比较两组患者早期液体患者复苏前、复苏后的相关指标,分析影响短期预后的因素。结果:复苏前,存活组心指数(CI)、平均动脉压(MAP)高于死亡组,差异有统计学意义(P<0.05);复苏后,两组CI、全身外周血管阻力、MAP、血管外肺水(ELWI)、肺血管通透性指数、心功能指数比较,差异有统计学意义(P<0.05)。液体复苏6 h后与短期转归有明显关联。结合各参数值进一步回归分析,结果表明仅ELWI 7d对预后呈正性相关。结论:应用PICCO的BCT参数在早期液体复苏前后与血流动力学参数、BST的相关性分析及对脓毒性休克患者短期预后的预测价值。

Objective:To investigate the predictive value of PICCO BCT parameters on the short-term prognosis of patients with septic shock.Methods:Forty-seven patients with septic shock admitted to the Department of Intensive Care Medicine of Maoming People's Hospital from January 2021 to August 2022 were selected as observation subjects,and the patients were divided into survival group(n=26)and death group(n=21)according to their Td survival.Indicators were measured to compare related index before and after resuscitation of patients with early fluids in both groups,and to analyze the factors affecting short-term prognosis.Results:Before resuscitation,cardiac index(CI)and mean arterial pressure(MAP)in survival group were significantly higher than those in death group(P<0.05).After resuscitation,there were significant differences in CI,systemic peripheral vascular resistance,MAP,extravascular lung water(ELWI),pulmonary vascular permeability index and cardiac function index between the two groups(P<0.05).There was a significant correlation between fluid resuscitation and short-term outcome after 6 h.Further regression analysis combined with various parameter values showed that only ELWI 7d was positively correlated with prognosis.Conclusion:Application of PICCO's BCT parameters before and after early fluid resuscitation was analyzed for correlation with hemodynamic parameters,BST and predictive value of short-term prognosis in patients with septic shock.