| 摘要: |
| 目的 探讨PiCCO监测和超声检查分别用于指导脓毒症患者早期液体复苏的效果差异。 方法 2017年12月-2018年12月,用随机数字表将沧州市人民医院重症医学科98例脓毒症确诊患者随机分为对照组(PiCCO监测为依据指导早期液体复苏)和试验组(超声检查为依据指导早期液体复苏),比较两组患者一般临床资料(HR、MAP、尿量、SvO2)、量表评分(APACHE Ⅱ和SOFA)、生化指标含量(IL-10、ET-1、NT-proBNP、LAC)的组内、组间差异。 结果 治疗后相比治疗前,两组患者HR、APACHE Ⅱ和SOFA评分IL-10、ET-1、LAC含量均有下降,而MAP、尿量、SvO2、NT-proBNP含量均有增加,组内差异均有统计学意义(P<0.01)。治疗后比较,试验组(104.51±10.34次/min)HR低于对照组(112.40±10.16次/min),试验组MAP(69.84±5.60mm Hg)、尿量(1393.51±180.95mL)、SvO2(75.63±6.27%)高于对照组(63.12±4.23mm Hg)、(969.74±169.89mL)、(69.22±5.38%),试验组APACHE Ⅱ(82.40±8.29分)、SOFA(22.60±2.63分)评分均低于对照组(97.23±5.13分)、(27.54±1.32分),试验组IL-10(35.27±3.63ng/L)、ET-1(152.63±12.94pg/L)、LAC(3.15±0.61mmol/L)含量均低于对照组(43.85±3.11ng/L)、(212.02±15.73pg/L)、(4.86±1.04mmol/L),试验组(4561.12±384.50ng/mL)NT-proBNP含量高于对照组(4106.07±403.99ng/mL),组间差异均有统计学意义(P<0.01)。 结论 超声检查用于指导脓毒症患者早期液体复苏,相比PiCCO监测的效果更好,能显著降低体内炎症状态,增强心功能及血氧状况。 |
| 关键词: PiCCO监测 超声检查 脓毒症 早期 液体复苏 急性生理与慢性健康评分 序贯脏器衰竭评分评分 炎症状况 |
| DOI： |
| 投稿时间：2020-09-07修订日期：2020-10-10 |
| 基金项目:沧州市科技支撑计划项目(编号：172302021) |
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| Comparison of the efficacy of PiCCO monitoring and ultrasound in guiding early fluid resuscitation in patients with sepsis |
| 要莉莉 |
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| Abstract: |
| objective To explore the differences in the efficacy of PiCCO monitoring and ultrasound in guiding early fluid resuscitation in patients with sepsis. Methods In December 2017 - December 2018, with a random number table cangzhou people"s hospital of intensive medicine confirmed 98 cases of sepsis patients were randomly divided into control group (PiCCO monitor based on guidance of early fluid resuscitation) and experimental group (ultrasound guidance on the basis of early fluid resuscitation), compared two groups of patients with general clinical data (HR, MAP, urine output, SvO2) and rating scale (APACHE Ⅱ and SOFA), biochemical index content (IL - 10, ET - 1, NT - proBNP, LAC) within the group, the differences between groups. Result After treatment than before treatment, two groups of patients" HR, APACHE Ⅱ and SOFA score IL - 10, ET - 1, LAC content were decreased, and the MAP, urine output, SvO2, NT - proBNP content were increased, interclass difference had statistical significance (P< 0.01). After treatment, HR of the experimental group (104.51±10.34 times /min) was lower than that of the control group (112.40±10.16 times /min), MAP (69.84±5.60mm Hg), urine volume (1393.51± 180.95ml) and SvO2 (75.63±6.27%) of the experimental group were higher than those of the control group (63.12±4.23mm Hg), (969.74± 169.89ml) and (69.22±5.38%). Group APACHE Ⅱ (82.40 ± 8.29), the SOFA (22.60±2.63) score were lower than the control group (97.23 ±5.13), (27.54±1.32), The content of IL-10 (35.27±3.63ng/L), ET-1 (152.63±12.94pg/L), LAC (3.15±0.61mmol/L) in the experimental group was lower than that in the control group (43.85±3.11ng/L), (212.02±15.73pg/L), and (4.86±1.04mmol/L). The content of Nt-probNP in the experimental group (4561.12±384.50ng/mL) was higher than that in the control group (4106.07±403.99ng/mL). The differences between groups were statistically significant (P<0.01). Conclusions Ultrasound examination is used to guide early fluid resusitation in patients with sepsis, and has a better effect than PiCCO monitoring, which can significantly reduce inflammation in the body, enhance cardiac function and blood oxygen status. |
| Key words: PiCCO monitor Ultrasonic examination Sepsis Early Fluid resuscitation Acute physiology and chronic health score Sequential organ failure score Inflammatory conditions |
