PICCO在重症冠脉搭桥术后容量管理中的应用价值

目的探讨脉搏指数连续心输出量(PICCO)在重症冠脉搭桥术后容量管理中的应用效果。方法选取2017年10月至2018年12月某三级甲等医院收治的58例行冠脉搭桥术患者的临床资料,根据治疗方法分为中心静脉压(CVP)组(30例)和PICCO组(28例),比较两组术后1,2,3 d的各项血流动力学指标和治疗期间的各项住院相关指标。结果PICCO组患者术后3 d的液体入量、尿量及动脉血Lac均低于CVP组,MAP高于CVP组(P<0.05),并发症发生率、机械通气时间、IABP置管时间及ICU监护时间均低于CVP组(P<0.05),两组术后28 d死亡率比较差异无统计学意义(P>0.05)。结论PICCO监测对指导重症冠脉搭桥术后容量管理有积极作用,有效地护理干预可提高监测效果。

Application value of PICCO in volume management after severe coronary artery bypass surgery

Objective To investigate the application effect of pulse-induced contour cardiac output(PICCO)in volume management after severe coronary artery bypass surgery.Methods To select the clinical data of 58 patients undergoing coronary bypass surgery in a tertiary first-class hospital from October 2017 to December 2018 and divided into the central venous pressure(CVP)group(30 cases)and the PICCO group(28 cases)according to the treatment method.The hemodynamic indexes and hospitalization-related indexes of the two groups after 1,2,and 3 days after operation were compared between the two groups.Results The fluid intake,urine output,and arterial blood Lac of patients on the 3 days after surgery in the PICCO group were lower than those in the CVP group,and MAP was higher than that in the CVP group(P<0.05).The incidence of complications,mechanical ventilation time,IABP catheterization time,and ICU monitoring time in the PICCO group were all lower than those of the CVP group(P<0.05).There was no significant difference in mortality between the two groups after postoperative 28 days(P>0.05).Conclusion The PICCO monitoring had a positive effect on guiding volume management after severe coronary artery bypass surgery.The effective nursing intervention should implement to improve the monitoring effect.