| 林冬阳,周海军,朱 明,胡 燕,苏 喆.PICCO在老年髋关节手术麻醉及血流动力学优化中的应用[J].,2018,(6):1073-1076 |
| PICCO在老年髋关节手术麻醉及血流动力学优化中的应用 |
| Application of PICCO for Anesthesia and Hemodynamic Optimization in Hip Surgery in Senile Patients |
| 投稿时间：2017-08-07 修订日期：2017-08-30 |
| DOI：10.13241/j.cnki.pmb.2018.06.014 |
| 中文关键词: 脉搏指示持续心输出量技术 老年 髋关节手术 麻醉 血流动力学 |
| 英文关键词: Pulse induced contour crdic output Senile patients Hip surgery Anesthesia Hemodynamics |
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| 中文摘要: |
| 摘要 目的：探讨脉搏指示持续心输出量(pulse induced contour crdic output，PICCO)技术在老年髋关节手术麻醉及血流动力学优化中的临床应用。方法：将106例老年髋关节手术患者随机分成2组，每组各53例。常规组放置中心静脉导管和动脉导管，PICCO组放置PICCO，检测平均动脉压（mean arterial pressure，MAP）、中心静脉压（central venous pressure，CVP）、心率（heart rate，HR）、心指数(cardiac index，CI)、血管外肺水指数(extravascular lung water index，ELWI)、胸腔内血容量指数(intrathoracic blood volume index，ITBI)及肺血管通透性指数(pulmonary vascular permeability index，PVPI)等血流动力学参数。记录PICCO组术中各指标的变化，比较分析两组术后前3天液体输入量，术后并发症发生情况。结果：与T0时点比较，PICCO组T1时点的MAP、CVP、CI、ITBI明显降低，HR明显升高(P<0.05)；T2时点MAP、CVP、CI较T1明显升高，HR明显下降(P<0.05)；PICCO组T2时刻各血流动力学指标均明显优于常规组(P<0.05)。PICCO组术后前3天的液体入量明显少于常规组(P<0.05)；ELWI与PVPI、ITBI、液体入量均呈高度正相关(P<0.05)。且PICCO组术后肺部感染及心血管并发症的发生率也较常规组明显降低(P<0.05)。结论：PICCO监测可准确反映血流动力学状态参数，指导临床麻醉和围术期液体管理，减少术中术后不良并发症，改善患者预后。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application of pulse induced contour crdic output (PICCO) for anesthesia and hemodynamic optimization in hip surgery in senile patients. Methods: 106 senile patients received hip surgery were randomly and equally divided into two groups. General group was given central venous catheter and ductus arteriosus for hemodynamic monitoring, and PICCO group was given PICCO to obtain the hemodynamic indicators including mean arterial pressure(MAP), central venous pressure(CVP), heart rate(HR), cardiac index(CI), extravascular lung water index(ELWI), intrathoracic blood volume index(ITBI), pulmonary vascular permeability index(PVPI). Results: Compared with T0, There were lower in the numerous of MAP, CVP, CI, ITBI, and higher HR than those of T1, the numerous of MAP, CVP, CI at T2 were higher, HR was lower than those at T1(P<0.05). The indicators of hemodynamic at T2 in PICCO group were significantly higher than those in general group(P<0.05). The fluid intake of PiCCO group were less than those of general group(P<0.05). ELWI has significant positive relationship with PVPI, ITBI, fluid intake (P<0.05), the complications incidence of postoperative pulmonary infection and cardiovascular were remarkably lower than those of general group (P<0.05). Conclusion: PICCO monitoring can accurately reflect the hemodynamic parameters, guide the clinical anesthesia and perioperative fluid management, reduce intraoperative and postoperative complication, improve the prognosis. |
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