脉搏指数连续心输出量技术在重度颅脑损伤患者液体管理中的应用效果评价

Effect of pulse index continuous cardiac output technology in fluid management of patients with severe craniocerebral injury

  • 摘要:
    目的 探讨以脉搏指数连续心输出量(PICCO)技术为指导的液体管理对重度颅脑损伤患者住院时间及并发症的影响。
    方法 将90例重度颅脑损伤患者按照不同液体管理方式分为2组。对照组患者(n=45)采取以中心静脉压(CVP)技术为指导的液体管理, 观察组患者(n=45)采取以PICCO技术为指导的液体管理。比较2组患者治疗前和治疗后2周的格拉斯哥昏迷量表(GCS)评分; 比较2组患者术后6个月的格拉斯哥预后量表(GOS)评分; 比较2组患者日平均液体量、ICU时间、住院时间; 记录2组患者死亡情况及并发症发生情况。
    结果 治疗后2周, 2组GCS评分比较,差异无统计学意义(P>0.05);观察组术后6个月GOS评分低于对照组,差异无统计学意义(P>0.05)。观察组死亡率为4.44%(2/45), 低于对照组的6.67%(3/45), 差异无统计学意义(P>0.05)。观察组日平均液体量、ICU时间、住院时间均低于对照组,差异有统计学意义(P < 0.05)。对照组并发症总发生率为28.89%, 高于观察组的11.11%, 差异有统计学意义(P < 0.05)。
    结论 PICCO技术在重度颅脑损伤患者液体管理中能够降低并发症风险,缩短ICU时间及住院时间,减少肺水肿、急性肺损伤、外伤性脑梗死等并发症的发生。

     

    Abstract:
    Objective To explore the effects of fluid management guided by pulse index continuous cardiac output (PICCO) technology on hospital stay and complications in patients with severe craniocerebral injury.
    Methods A total of 90 patients with severe craniocerebral injury were divided into two groups according to different fluid management methods. Patients in control group (n=45) were treated with fluid management guided by central venous pressure (CVP) technology, while the patients in observation group (n=45) were treated with fluid management guided by PICCO technology. Scores of the Glasgow Coma Scale (GCS) before treatment and 2 weeks after treatment were compared between the two groups; score of the Glasgow Outcome Scale (GOS) was compared between the two groups at 6 months after surgery; the average daily fluid volume, length of time in ICU and hospital stay were compared between two groups; death and complications in both group were recorded.
    Results Two weeks after treatment, there was no significant difference in GCS score between the two groups (P>0.05); six months after operation, the GOS score of the observation group was lower than that of the control, but there was no significant difference between two groups (P>0.05). The mortality in the observation group was 4.44% (2/45), which was lower than 6.67% (3/45) in the control group, but there was no significant difference between two groups (P>0.05). The average daily fluid volume, length of time in ICU and hospital stay in the observation group were significantly lower than those in the control group (P < 0.05). The total incidence of complications in the control group was 28.89%, which was significantly higher than 11.11% in the observation group (P < 0.05).
    Conclusion PICCO technology can reduce the risk of complications in severe craniocerebral injury patients with fluid management, shorten length of time in ICU and hospital stay, and reduce the occurrence of complications such as pulmonary edema, acute lung injury and traumatic cerebral infarction.

     

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