發(fā)布時(shí)間：2018-05-27 03:08

  本文選題：呼吸窘迫綜合征 + 兒童　； 參考：《重慶醫(yī)學(xué)》2017年19期

【摘要】：目的探討脈搏指示輪廓連續(xù)心排血量技術(shù)(PiCCO)在指導(dǎo)高頻通氣治療兒童急性呼吸窘迫綜合征(ARDS)液體容量管理治療及判斷預(yù)后的意義,為ARDS患兒的治療提供新的參考。方法選取2013年1月至2015年8月入住該院兒科重癥監(jiān)護(hù)病房(PICU)的確診ARDS患兒56例,將其按入院住院號(hào)奇偶數(shù)分為觀察組與對(duì)照組,兩組患兒均給予常規(guī)監(jiān)護(hù)及治療,觀察組在此基礎(chǔ)上應(yīng)用PiCCO對(duì)血流動(dòng)力學(xué)的變化進(jìn)行監(jiān)測(cè),并根據(jù)結(jié)果進(jìn)行早期積極的液體容量管理,對(duì)照組給予經(jīng)驗(yàn)性液體治療管理。比較兩組患兒的血流動(dòng)力學(xué)指標(biāo)、氧合指數(shù)(OI)及預(yù)后。結(jié)果與對(duì)照組比較,觀察組危重癥評(píng)分在治療24、72h時(shí)均明顯升高,OI均明顯下降,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組機(jī)械通氣時(shí)間和PICU入住時(shí)間明顯較對(duì)照組短,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組存活患兒與死亡患兒血管外肺水指數(shù)(EVLWI)比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論應(yīng)用PiCCO指導(dǎo)高頻通氣兒童ARDS早期液體治療能有效縮短患兒機(jī)械通氣時(shí)間和PICU入住時(shí)間,對(duì)改善預(yù)后無(wú)明顯影響。
[Abstract]:Objective to explore the clinical significance of continuous cardiac output with pulse indicating profile in guiding high frequency ventilation in the treatment of children with acute respiratory distress syndrome (ARDS) and its prognosis, and to provide a new reference for the treatment of children with acute respiratory distress syndrome (ARDS). Methods from January 2013 to August 2015, 56 children with ARDS admitted to pediatric intensive care unit (PICU) were divided into observation group and control group according to the number of hospital admission. The two groups were given routine care and treatment. On this basis, PiCCO was used to monitor hemodynamic changes in the observation group, and early and active liquid volume management was carried out according to the results, while the control group was administered with empirical fluid therapy. Hemodynamic indexes, oxygenation index (OI) and prognosis were compared between the two groups. Results compared with the control group, the scores of critical disease in the observation group were significantly higher than those in the control group at 2472h, and the difference was statistically significant (P 0.05), and the time of mechanical ventilation and PICU stay in the observation group was significantly shorter than that in the control group (P 0.05). There was no significant difference in extravascular pulmonary water index (EVLWI) between surviving and dead children in the observation group (P 0.05). Conclusion early liquid therapy of ARDS in children with high frequency ventilation guided by PiCCO can effectively shorten the time of mechanical ventilation and stay of PICU, and has no effect on the prognosis.
【作者單位】： 鄭州兒童醫(yī)院PICU;
【基金】：河南省衛(wèi)生科技攻關(guān)項(xiàng)目(201303233)
【分類號(hào)】：R720.597

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