脉搏指示连续心排血量监护仪在老年感染性休克液体复苏治疗中的应用

目的探讨脉搏指示连续心排血量(PICCO)监测技术对老年感染性休克液体复苏治疗的指导意义。方法 24例老年感染性休克患者分为观察组和对照组,每组12例。观察组患者在PICCO监护仪监测指导下补液治疗,对照组患者在监测中心静脉压指导下补液治疗;观察比较2组治疗效果。结果治疗第1天,2组患者白细胞、中性粒细胞计数、混合静脉血氧饱和度(SvO2)、血降钙素原(PCT)和乳酸(LA)水平比较差异均无统计学意义(P>0.05);治疗第2、3天,观察组患者白细胞、中性粒细胞计数、血LA和PCT水平均显著低于对照组(P<0.05),SvO2显著高于对照组(P<0.05)。观察组患者机械通气时间显著短于对照组(P<0.05),28 d病死率低于对照组(P<0.05)。结论PICCO监护仪对老年感染性休克液体复苏治疗有重要的指导意义,可以显著改善患者血气分析指标,缩短患者机械通气时间,降低病死率。

Application of pulse indicator continuous cardiac output monitor in the fluid resuscitation therapy in elderly patients with septic shock

Objective To investigate the guiding significance of pulse indicator continuous cardiac output(PICCO) for the fluid resuscitation in elderly patients with septic shock.Methods Twenty-four elderly patients with septic shock were divided into observation group and control group,twelve cases in each group.The patients in observation group were treated with fluid resuscitation under the guidance of PICCO monitor,while the patients in control group were treated with fluid resuscitation under the guidance of monitoring central venous pressure,then the curative effect was compared between the two groups.Results On the first day of treatment,there was no statistical difference in the blood cell and neutrophil counts,mixed venous oxygen saturation(SvO2),the levels of procalcitonin(PCT) and lactic acid(LA) between the two groups(P>0.05).On the second and third days of treatment,the white blood cell,neutrophil counts and the levels of LA and PCT in observation group were significantly lower than those in control group(P<0.05),but SvO2 was significantly higher(P<0.05).Compared with control group,the mechanical ventilation time was significantly shorter(P<0.05),and the case fatality within 28 days was lower in observation group(P<0.05).Conclusion PICCO monitor has important guiding significance in the treatment of fluid resuscitation in elderly patients with septic shock,which can significantly improve blood gas analysis index,shorten the mechanical ventilation time and reduce mortality.