不同监测手段对脓毒性休克并发心功能不全患者治疗效果的影响

目的比较脉搏指示连续心排血量(PICCO)和中心静脉压(CVP)监测对脓毒性休克并发心功能不全患者治疗的指导意义。方法选取于2017年6月至2019年12月在连州市人民医院就诊的60例脓毒性休克并发心功能不全患者,采用随机数字表法分为常规组和观察组各30例。常规组进行CVP监测指导治疗,观察组进行PICCO监测指导治疗。比较两组治疗效果及血流动力学指标。结果两组采用不同监测手段实施治疗方案后B型脑钠肽(BNP)、心率(HR)、CVP均降低,而平均动脉压(MAP)升高,两组BNP、HR、MAP比较,差异有统计学意义(P<0.01)。两组治疗后随着时间急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均不同程度降低,与常规组,观察组治疗后降低更显著,差异有统计学意义(P<0.01)。与治疗前相比,观察组体循环阻力指数(SVRI)、心排血指数(CI)均显著升高,CO则显著降低,差异有统计学意义(P<0.01)。结论较常规监测方式,PICCO监测指标指导患者早期容量复苏方案效果更佳,有助于病情控制。

Effect of different monitoring methods on treatment of septic shock complicated with cardiac insufficiency

【Objective】To compare the guiding significance of pulse indicating continuous cardiac output(PICCO)and central venous pressure(CVP)monitoring in the treatment of septic shock complicated with cardiac insufficiency.【Methods】From June 2017 to December 2019,60 patients with septic shock complicated with cardiac insufficiency were recruited and divided into routine group(30 cases)and observation group(30 cases).The routine group was monitored and guided by CVP,and the observation group was monitored and guided by PICCO.The therapeutic effect and hemodynamic indexes of the two groups were compared.【Results】BNP,HR,CVP decreased and MAP increased in the two groups after the treatment with different monitoring methods,and the difference between the two groups was statistically significant(P<0.01).After treatment,APACHEⅡscore of the two groups decreased in different degrees with the time,and it was significantly lower in the observation group than in the routine group(P<0.01).In the observation group,SVRI and CI were significantly higher than those before treatment,while CO was significantly lower(P<0.01).【Conclusion】Compared with the routine monitoring method,PICCO monitoring index is more effective in guiding patients with early volume resuscitation program,which is helpful for disease control.