PICCO指导重型颅脑损伤患者容量管理的效果

目的探讨脉搏指数连续心排血量监测(PICCO)指导重型颅脑损伤患者容量管理的效果。方法回顾性分析60例重型颅脑损伤患者的临床资料,按照护理方法不同将患者分为对照组和观察组,各30例。对照组给予常规护理,观察组在对照组基础上给予PICCO指导下容量管理。比较两组的护理效果。结果干预2周后,两组的GCS评分均升高,APACHEⅡ评分均降低,且观察组优于对照组(P<0.05)。干预48 h后,两组的PaO2/FiO2均升高,乳酸、BNP水平及CVP均降低,且观察组优于对照组(P<0.05)。观察组的日平均液体量少于对照组,机械通气时间及住院时间均短于对照组,肺水肿发生率低于对照组(P<0.05)。结论PICCO指导重型颅脑损伤患者的容量管理效果显著,能快速改善患者疾病危重程度,降低肺水肿发生率。

Effect of PICCO in guiding the volume management of patients with severe craniocerebral injury

Objective To investigate the effect of pulse index continuous cardiac output(PICCO)in guiding the volume management of patients with severe craniocerebral injury.Methods The clinical data of 60 patients with severe craniocerebral injury were retrospectively analyzed.The patients were divided into control group and observation group by different nursing methods,with 30 cases in each group.The control group was given routine nursing,and the observation group was given the volume management under PICCO guidance on the basis of the control group.The nursing effects of the two groups were compared.Results After 2 weeks of intervention,GCS score in the two groups improved,APACHEⅡscore decreased,and those in the observation group were better than the control group(P<0.05).After 48 h of intervention,PaO2/FiO2 in the two groups increased,the levels of lactic acid,BNP and CVP decreased,and those in the observation group were better than the control group(P<0.05).The average daily fluid volume in the observation group was less than that in the control group,and the mechanical ventilation time and hospitalization time were shorter than those in the control group,the incidence of pulmonary edema was lower than that in the control group(P<0.05).Conclusion PICCO in guiding the volume management of patients with severe craniocerebral injury has significant effect,it can quickly improve the severity degree of the disease,reduce the incidence of pulmonary edema.