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目的总结每小时一平衡的容量管理模式对重症监护室(ICU)危重症病人血液动力学特性的影响。方法从实施每小时一平衡的容量管理前后2年内各随机抽取41例病人分为两组进行历史对照研究,分别观察心率、平均动脉压、中心静脉压、动脉血氧分压、多巴胺的用量、预后等指标。结果实施每小时一平衡的容量管理后与实施前病例组相比:实施后组各病人72 h内心率变异系数均值、动脉血氧分压变异系数均值明显小于实施前组,两组比较差异有统计学意义(P均<0.01);实施后组72 h内平均动脉压、动脉血氧分压明显高于实施前组,两组比较差异有统计学意义(P均<0.01);实施后组72 h内心率、多巴胺用量明显低于实施前组,两组比较差异有统计学意义(P均<0.01);实施前病死率为71%,实施后为49%,两组比较差异有统计学意义(P<0.05)。结论每小时一平衡的容量管理模式能够稳定危重症病人血流动力学特性,改善心肺功能,降低危重症病人病死率。
Objective To summarize the impact of hourly balanced volume management on the hemodynamic characteristics of critically ill patients in intensive care unit (ICU). Methods A total of 41 patients were randomly divided into two groups. The control group was divided into two groups: control group, heart rate, mean arterial pressure, central venous pressure, arterial partial pressure of oxygen, dosage of dopamine, Prognosis and other indicators. Results Compared with the pre-implementation case group, after the balanced hourly volume management, the mean intra-cardiac coefficient of variation and the coefficient of variation of arterial oxygen partial pressure in each group were significantly lower than those of the pre-implementation group (P <0.01). The mean arterial blood pressure and arterial oxygen tension within 72 hours after the implementation of the treatment group were significantly higher than those before the implementation, the difference between the two groups was statistically significant (P <0.01) The heart rate and the amount of dopamine in 72 h were significantly lower than those in the control group (P <0.01). The mortality rate before implementation was 71%, and 49% after implementation. The differences between the two groups were statistically significant Significance (P <0.05). Conclusion The balanced hourly volume management mode can stabilize the hemodynamic characteristics of critically ill patients, improve cardiopulmonary function and reduce the mortality of critically ill patients.