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目的探讨脉搏指示连续心排血量(PICCO)监测在机械通气治疗老年危重患者中的临床应用价值。方法患者资料来源于2015年1月—2016年12月就诊于该院重症医学科及神经外科监护室内机械通气治疗的76例患者,采用回顾性方法进行研究,将其分为对照组(36例)与观察组(40例),观察并记录二种监测方法对患者临床治疗的指导意义。结果观察组患者在治疗24h及治疗48h后的心率(HR)、平均动脉压(MAP)、血乳酸(LAC)、尿量及碳酸氢根均与对照组患者差异有统计学意义(P<0.05),观察组患者机械通气时间、住院时间及死亡人数均显著少于对照组,且差异具有统计学意义(P<0.05),二组患者活化部分凝血酶原时间(APTT)及血浆凝血酶原时间(PT)之间差异无统计学意义(P>0.05)。结论中心静脉压(CVP)监测对机械通气老年患者临床治疗具有较为显著的指导意义,联合应用PICCO,其指导价值更为突出,值得广泛开展于临床中。
Objective To investigate the clinical value of pulsed-guided continuous cardiac output (PICCO) monitoring in the treatment of elderly critically ill patients with mechanical ventilation. Methods The data of patients from January 2015 to December 2016 76 patients admitted to Department of Critical Care and Neurosurgery Nursing Home Mechanical Ventilation in our hospital from January 2015 to December 2016 were retrospectively studied and divided into control group (36 cases ) And observation group (40 cases), observed and recorded two kinds of monitoring methods on the clinical significance of the patient. Results The heart rate (HR), mean arterial pressure (MAP), blood lactic acid (LAC), urine output and bicarbonate in the observation group were significantly different from those in the control group at 24h and 48h (P <0.05 ), The observation group patients with mechanical ventilation time, hospital stay and death were significantly less than the control group, and the difference was statistically significant (P <0.05), two groups of patients with activated partial prothrombin time (APTT) and plasma prothrombin There was no significant difference between time (PT) (P> 0.05). Conclusions The monitoring of central venous pressure (CVP) has a significant guiding significance for the clinical treatment of elderly patients with mechanical ventilation. Combined with PICCO, its guiding value is more prominent and worthy of extensive clinical application.