PICCO指导的液体管理在失血性休克合并肺水肿治疗中的意义

彭开毅 吴馨馨 黄祥卫 王 铮

PICCO指导的液体管理在失血性休克合并肺水肿治疗中的意义

彭开毅 吴馨馨 黄祥卫 王 铮

目的 分析在失血性休克合并肺水肿患者的临床治疗中，PICCO监测指导下的液体管理的具体应用意义。方法 选取我院于2014年6月～2016年1月收治的40例失血性休克合并肺水肿患者为研究对象，将所选患者随机分为对照组与干预组，对照组患者接受中心静脉压和胸片监测，干预组患者则接受PICCO监测，监测数据用于指导下一阶段治疗的液体管理方案。对比两组患者治疗72 h后的主要指标情况。结果 干预组患者的相关指标要明显优于对照组患者，两组患者的数据经对比后存在明显的统计学差异（P＜0.05）。结论 在失血性休克合并肺水肿患者的临床治疗中，PICCO监测指导下的液体管理具有较好的应用意义，故在此类病人中值得推广。

PICCO监测；中心静脉压监测；失血性休克；肺水肿

【Abstract】

Objective To analyze the clinical treatment of hemorrhagic shock in patients with pulmonary edema in the application significance of fluidmanagement under the guidance of PICCO monitoring. Methods 40 cases with loss of hemorrhagic shock with pulmonary edema were selected in our hospital from June 2014 to January 2016 as the research objects，the selected patients were randomly divided into control group and intervention group. Control group patients received central venous pressure and chest X-ray monitoring，the intervention group were accepted PICCO monitoring，dual monitoring data were used to guide the next phase of treatment fluid management solutions. Compared two groups of patients after major indicators 72 h. Results The indexes of the intervention group patients were significantly better than those of patients in the control group，two groups data were compared and had statistically significant difference（P＜0.05） . Conclusion In the clinical treatment of patients with hemorrhagic shock with pulmonary edema，PICCO monitoring under the guidance of the liquid management has a good sense of application，it is worth promoting in this category of patients.

【Key words】PICCO monitoring，Central venous pressure monitoring，Hemorrhagic shock，Pulmonary edema

目前，我国失血性休克合并肺水肿患者的数量正在不断增加，患者患病后若未能及时接受科学抢救治疗，生命安全会受到严重影响。PICCO监测，也被称作为脉波指示剂连续心排血量监测，是目前临床中最为常用的液体复苏治疗方法［1-2］。PICCO监测可以很好地将脉搏分析技术与肺热稀释方法相结合，操作十分方便，对于患者的各项主要指标可以进行较好监测［3-4］。我院在失血性休克合并肺水肿患者的治疗中应用PICCO监测，并根据监测数据以制定下一阶段治疗的液体管理，收到较好临床效果，现作以下报道。……