论文部分内容阅读
目的:研究超声心动图指导心脏术后患者容量管理的临床效果。方法:选取2016年7月-2016年12月我院心外ICU收治的79例成人心脏病术后循环不稳的患者。将入选患者随机分为超声心动图指导容量管理组(A组)、常规容量管理组(B组)及脉波指示剂连续心排血量法(Pi CCO)指导容量管理组(C组)。记录治疗前(T0)、治疗开始后第4小时(T1)、第12小时(T2)、第24小时(T3)、第48小时(T4)3组患者的循环灌注指标;T0、T4时的心功能指标及预后。结果:与B组相比,A组T1、T2时的循环灌注指标明显改善(P<0.05),T4时动脉血BNP浓度下降(P<0.05);并发症发生率、机械通气时间及ICU住院时间均下降(P<0.05),但28天死亡率无统计学差异;与C组相比,A组所有指标无统计学差异。结论:超声心动图用于指导心脏术后患者容量管理,可良好维持机体血流动力学稳定及脏器灌注,改善心肺功能,降低并发症发生率,与Pi CCO指导容量管理方案临床效果无差异。
Objective: To study the clinical effect of echocardiography in the management of cardiac volume after cardiac surgery. Methods: From July 2016 to December 2016, 79 patients with unstable circulation of heart disease after cardiac surgery in our hospital were selected. The selected patients were randomly divided into echocardiographic guidance capacity management group (group A), conventional capacity management group (group B) and pulse wave indicator continuous cardiac output (Pi CCO) guidance capacity management group (group C). The perfusion parameters of three groups were recorded before treatment (T0), at 4h (T1), 12h (T2), 24h (T3) and 48h after treatment (T4) Cardiac function and prognosis. Results: Compared with group B, the indexes of perfusion at T1 and T2 were significantly improved in group A (P <0.05), and the concentration of BNP in arterial blood was decreased at T4 (P <0.05). The complication rate, duration of mechanical ventilation and hospital stay (P <0.05), but there was no significant difference in the 28-day mortality rate. Compared with the C group, all the indexes in the A group showed no significant difference. Conclusions: Echocardiography is used to guide the capacity management of postoperative cardiac surgery. It can maintain the hemodynamic stability and organ perfusion, improve cardiorespiratory function and reduce the incidence of complications. There is no difference between PiCCO guided capacity management and clinical management .