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目的:探讨脉搏指数连续心排出量(pulse indicated continuous cardiac output,PiCCO)监测在复杂性先天性心脏病患儿围术期治疗的指导意义。方法:选取复杂性先天性心脏病矫治术后的患儿104例,随机分为两组,PiCCO组(51例),均放置PiCCO导管监测平均动脉压(MAP)、心输出量(CO)、连续心输出量(CCO)、外周血管阻力(SVR)、胸腔内血容量(ITBV)、全心舒张末期容量(GEDV)、血管外肺水(EVLW)等,并指导临床治疗。对照组(53例),不放置PiCCO导管,凭经验及其他常规指标指导治疗。结果:PiCCO组机械通气时间、ICU滞留时间、血管活性药物使用时间显著短于对照组,但两组患儿左室射血分数(LVEF)、脑钠尿肽(BNP)、胸片渗出情况、感染率、病死率均无统计学差异。结论:PiCCO技术在复杂性先天性心脏病患儿术后治疗中有一定的实用价值。
Objective: To investigate the clinical significance of monitoring pulse duration continuous cardiac output (PiCCO) monitoring in perioperative period in children with complex congenital heart disease. Methods: A total of 104 children with complicated congenital heart disease were randomly divided into two groups: PiCCO group (51 cases), mean arterial pressure (MAP), cardiac output (CO) (CCO), peripheral vascular resistance (SVR), intrathoracic blood volume (ITBV), total end-diastolic volume (GEDV), extravascular lung water (EVLW) and so on, and guide the clinical treatment. Control group (n = 53) without PiCCO catheter, guided by experience and other routine indicators. Results: The duration of mechanical ventilation, ICU residence time and vasoactive drug use time in PiCCO group were significantly shorter than those in control group. However, the LVEF, BNP, , Infection rate, fatality rate no statistical difference. Conclusion: PiCCO technique has some practical value in the treatment of complicated congenital heart disease in children.