PiCCO技术对复杂先天性心脏病患儿围手术期治疗的意义

汪 洋; 郑 萍; 祁 明

PiCCO技术对复杂先天性心脏病患儿围手术期治疗的意义

Application of pulseindicated continuous cardiac output system in perioperative children with complex congenital heart disease

摘要

摘要: 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。

Abstract: AIM:To evaluate the application of pulseindicated continuous cardiac output (PiCCO) system in perioperative children with complex congenital heart disease. METHODS: One hundred and four children with complex congenital heart disease were randomly divided into two groups. MAP, CO, CCO, SVR, ITBV, GEDV, and EVLW were measured after surgery in Group A (n=51), whereas patients in Group B (n=53) were treated by experience and other indexes without application of PiCCO. RESULTS: The time of mechanical ventilation, ICU stay and administration of positive inotropic drugs in Group A were significantly shorter than in Group B. No statistical differences were observed in LVEF, BNP, pleural effusion, rate of infections and mortality between groups. CONCLUSION: The application of PiCCO is beneficial in the treatment of perioperative children with complex congenital heart disease.

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