PiCCO在脓毒性休克患者EGDT中的研究进展(综述)

Research Progress of PiCCO on EGDT in Patients with Septic Shock

摘要: 脓毒性休克(Septic shock)是由于全身性感染导致多器官功能受损为特点的一种综合征，是重症加强治疗病房(Intensive care unit, ICU)患者常见的死亡原因之一。脓毒性休克患者的主要临床表现为血流动力学紊乱，因此精确的血流动力学评估和快速准确的液体复苏对疾病的治疗非常重要。PiCCO即脉搏指示连续性排出量监测(Pulse indicator continuous cardiac output)，是一种结合动脉脉搏轮廓连续心排血量监测与经肺热稀释心排血量监测的新型血流动力学监测技术，具有临床操作简单、对患者机体损伤小、参数更直观全面等优点，能更好地指导脓毒性休克患者早期目标导向液体治疗(Early goal directed fluid therapy, EGDT)，减少因过度补液引起的肺水肿和肺部感染加重，减少心功能衰竭的发生，提高液体复苏治疗成功率，有助于患者近期的综合治疗，但对于脓毒性休克患者远期转归无明显改善。

Abstract: Septic shock is a syndrome characterized by multiple organ dysfunction due to systemic infection. It is one of the common causes of death in Intensive Care Unit (ICU) patients. The main clinical manifestation of septic shock patients is hemodynamic disorder, so accurate hemodynamic as-sessment and rapid and accurate fluid resuscitation are very important for the treatment of the disease. PiCCO (Pulse indicator continuous cardiac output) is a new hemodynamic monitoring technology which combines arterial pulse contour continuous cardiac output monitoring and pulmonary heat dilution cardiac output monitoring. PiCCO has the advantages of simple clinical operation, small injury to patients, more intuitive and comprehensive parameters and so on. So it can better guide Early goal directed fluid therapy (EGDT) in patients with septic shock, reduce pulmonary edema and exacerbation of pulmonary infection caused by excessive fluid replacement, reduce the occurrence of heart failure, improve the success rate of liquid resuscitation and help patients to comprehensive treatment in the near future. However, there was no significant im-provement in the long-term outcome of patients with septic shock.