PiCCO监测下心肌梗死心源性休克患者实施精细容量管理的临床护理措施.pdfVIP

CHINESECOMMUNITYDOCTORS 护理论著 PiCCO监测下心肌梗死心源性休克患者实施 精细容量管理的临床护理措施 刘玉香 061100河北省黄骅市人民医院急诊科 doi:10.3969/j.issn.1007-614x.2016.21.96 摘 要 目的：探讨PiCCO监测下心肌梗死心源性休克患者实施精细容量管理的临床护理措施。方法：收治心肌梗 死心源性休克患者26例，采用PiCCO监测，根据监测结果对患者实施精细容量管理，观察效果。结果：干预后，患 者CI、CFI、MAP明显提高，ITBI、SVV、SVRI、CVP、ELWI明显下降，26例患者均明显好转，抢救成功率 100%。结论：PiCCO监测下可以密切关注患者血流动力学指数，并在此基础上提供全面的精细化护理，为患者合理 补液，及时调整用药，减少并发症，提高治疗效果。 关键词 PiCCO监测；心肌梗死；心源性休克；精细容量管理 Clinical nursing measures of fine volume management for myocardial infarction patients with cardiac shock underPiCCOmonitoring LiuYuxiang TheEmergencyDepartment,thePeoplesHospitalofHuanghuaCity,HebeiProvince061100 Abstract Objective:Toexploretheclinicalnursingmeasuresoffinevolumemanagementformyocardialinfarctionpatientswith cardiacshockunderPiCCOmonitoring.Methods:26myocardialinfarctionpatientswithcardiacshockwereselected.Theywere givenPiCCOmonitoring,accordingtothemonitoringresults.Weimplementedthefinevolumemanagementforpatients,and observed the effect.Results:After intervention,CI,CFI,MAP were significantly improved;ITBI,SVV,SVRI,CVP,ELWI were significantlydecreased.26casesweresignificantlyimproved,andtherescuesuccessratewas100%.Conclusion:InthePiCCO monitoring,wecanpaycloseattentiontothepatientswithhemodynamicindex.Basedonthis,wecanprovidecomprehensiveand meticulouscare,providereasonablefluidtherapyforpatients,timelyadjustmedication,reducecomplicationsandimprovethe therapeuticeffect. Keywords PiCCOmonitoring;Myocardialinfarction;Cardiacshock;Finevolumemanagement PiCCO(脉搏指示持续心输出量检测 于患者右颈内静脉途径留置中心静脉导 液量。②冰盐水的注入对PiCCO的有效 技术)是应用于重症患者的一种高效、简 管，同时于患者股动脉置入PiCCO专用 监测有着重要影响，所以对冰盐水的注 便的血流动力学检测工具[1]。利用PiCCO 导管，将床边监护仪与PiCCO监控模块 入操作要严格要求。推注盐水时要避免 检测技术对患者进行血液动力监测和容 连接。将20mL冰盐水于5s内快速注入 将血管活性药物注入中心静脉，此时中 量管理就不需要再放置肺动脉导管，而 中心静脉导管，以连接温度感知探头， 心静脉导管输液需停