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脉搏指示轮廓连续心输出量监测在缩窄性心包炎心包切除术患者中的临床意义。

Clinical significance of pulse index contour continuous cardiac output monitoring in patients with constrictive pericarditis undergoing pericardiectomy.

机构信息

Department of Nursing, Hangzhou Red Cross Hospital, Hangzhou, China.

Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, China.

出版信息

Interact Cardiovasc Thorac Surg. 2020 Sep 1;31(3):364-368. doi: 10.1093/icvts/ivaa110.

Abstract

OBJECTIVES

The efficacy of pulse index contour continuous cardiac output (PiCCO) monitoring in patients with constrictive pericarditis undergoing pericardiectomy remains unclear. The goal of this study was to explore whether PiCCO monitoring could improve clinical outcomes in these patients.

METHODS

We retrospectively studied 74 patients with constrictive pericarditis undergoing pericardiectomy and assigned them to a PiCCO group and a control group. Postoperative and survival outcomes were compared between the 2 groups.

RESULTS

There were 33 (44.6%) cases in the PiCCO group and 41 (55.4%) cases in the control group. The baseline characteristics were comparable between the 2 groups. In comparison to the control group, the PiCCO group showed more intraoperative fluid infusion (P = 0.003), higher postoperative central venous pressure (P = 0.007) and lower levels of postoperative brain natriuretic peptide (P = 0.021). The incidence of postoperative complications (P = 0.004) including cardiac complications (P = 0.033) was also lower in the PiCCO group. Despite no difference in survival outcomes, duration of chest drainage (P = 0.032), length of stay in the intensive care unit (P < 0.001) and the postoperative hospital stay (P = 0.044) were significantly shorter in the PiCCO group.

CONCLUSIONS

This study confirmed the clinical significance of PiCCO monitoring in the enhanced recovery of patients with constrictive pericarditis undergoing pericardiectomy and provided new evidence for applying PiCCO monitoring in these patients.

摘要

目的

脉冲指数轮廓连续心输出量(PiCCO)监测在心包缩窄症患者心包切除术中的疗效尚不清楚。本研究旨在探讨 PiCCO 监测是否能改善此类患者的临床结局。

方法

我们回顾性研究了 74 例行心包切除术的缩窄性心包炎患者,并将其分为 PiCCO 组和对照组。比较两组患者的术后和生存结局。

结果

PiCCO 组 33 例(44.6%),对照组 41 例(55.4%)。两组患者的基线特征无差异。与对照组相比,PiCCO 组术中输液量更多(P=0.003),术后中心静脉压更高(P=0.007),术后脑利钠肽水平更低(P=0.021)。PiCCO 组术后并发症(P=0.004)包括心脏并发症(P=0.033)的发生率也较低。尽管两组患者的生存结局无差异,但 PiCCO 组的术后胸腔引流时间(P=0.032)、重症监护病房住院时间(P<0.001)和术后住院时间(P=0.044)更短。

结论

本研究证实了 PiCCO 监测在心包缩窄症患者心包切除术后加速康复中的临床意义,并为 PiCCO 监测在这类患者中的应用提供了新的证据。

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