| Objective Explore the clinical effects of PiCCO monitoring technology applied to the early treatment of severe burn patients,analyze the relationship between PiCCO indicators,and guide the early treatment of severe burn patients.Methods From March 2012 to October 2020,60 patients with severe burns admitted to the Burns Department of Gan Su People’s Hospital were collected.According to whether PiCCO was used for early recovery after injury,they were divided into traditional treatment group 30 cases,PiCCO group 30 cases,and two Relevant baseline data of the group of patients,record the heart rate at 24 h,48h,72 h,5d,7d after injury,the intake and output of the first and second 24 h of the two groups,the daily blood lactate value and NT from the time of admission to the7 th day after injury NT-pro BNP,c Tn T indicators,cystatin C values and blood creatinine values immediately after admission,24 h after injury,48 h after injury,and 72 h after injury.CI,SVRI,EVLWI,GEDVI of patients in PiCCO group were collected from 6h to 164 h after injury.Use SPSS 26.0 for statistical processing.x±s represents the measurement data that meets the normal distribution.The overall comparison between groups uses repeated measurement analysis,and the pairwise comparison between groups uses F test and Bonferroni correction;data that does not meet the normal distribution is represented by M(P25,P75).Mann-Whitney U test was used.Frequency and percentage are expressed as count data,using X~2 test or Fisher’s exact probability test(the software automatically ignores the change of statistics),P<0.05 means that the difference is statistically significant.Results There was no statistically significant difference in the indicators of the two groups of patients when they were admitted to the hospital(P>0.05).Afterwards,with the progress of treatment,the differences in the changes of physiological indicators between the two groups of patients were statistically significant(P<0.05).For the patients in the PiCCO group,the overall difference in CI between 6h and 164 h after injury was statistically significant(F=71.862,P <0.01).The CIs at 6h,12 h,18h,24 h,and 30 h after injury were(2.91±0.47),(2.8±0.58),(3.13±0.54),(3.58±0.65)L·min-1· m~2,which is significantly lower than the normal value of 4L·min-1· m~2(t=-12.679,-11.404,-8.868,-3.655,P <0.01),the 12 h CI after the injury was the lowest;74h,80 h,86h,92 h,98h,after the injury,the CI of the patient was(5.12±0.28),(5.25±0.42),(5.69)±0.29),(5.58±0.29),(5.54±0.31)L·min-1· m~2,which are significantly higher than the normal value(t=21.567,16.091,32.165,29.97,27.231,9.448,P < 0.01),the CI value of the patients in the rest of the time was close to the normal value(P<0.05);the PiCCO group had a statistically significant difference in SVRI from 6h to 164h(F=82.409,P< 0.01),24 h after injury,At 30 h,36h,42 h,48h,56 h,62h,68 h,the SVRI of patients were(2623.03±218.46),(3038.47±304.67),(2834.97±243.34),(2775.6±242.95),(2647.07±331.53),(2591.63±361.75),(2581.83±336.41),(2500.4±323.96)dyn·s·cm-5· m~2,which was significantly higher than the normal value of 2050 dyn·s·cm-5·m~2,6h,12 h,74h after injury,80 h,86h,92 h,98h,the SVRI of the patients were(1490.57±174.84),(1809.57±229.64),(1764.47±408.74),(1680.13±377.88),(1632.23±379.81),(1633.67±331.11),(1684.97±293.18)significantly lower than the normal value(t=-17.525,-5.735,-3.826,-5.361,-6.025,-6.887,-6.82,-5.51,P< 0.01),other time points are close to the normal value.From 6h to 164 h after injury,the overall difference in GEDVI of patients was statistically significant(F=2.556,P<0.01).At 6h,12 h,18h,30 h,and 36 h,the patient’s GEDVI was lower than the normal value of 740 m L/m~2(t=-19.414,-2.901,-14.455,-12.044,-4.212,P<0.01),other time points were close to the normal value(P>0.05);6h-164 h after injury,the overall difference in EVLWI between patients was statistically significant(F= 52.459,P<0.01),18 h,24h,30 h,36h,42 h,48h after injury,the patient’s EVLWI was significantly higher than the normal value of 5m L/m~2(t=5.397,7.382,7.941,8.069,9.077,8.961,P <0.01),the other time is similar to the normal value(P>0.05);SVRI and EVLWI are positively correlated,the correlation coefficient is r=0.414,P<0.001.GEDVI has a positive correlation with CI,the correlation coefficient r=0.660,P < 0.001.There is no correlation between GEDVI and SVRI,the correlation coefficient value is r=-0.076,P>0.05.CI and SVRI have a negative correlation,the correlation coefficient r=-0.241,P<0.001.Conclusion 1.Compared with traditional monitoring technology,the application of PiCCO monitoring technology for severely burned patients has a better effect of correcting the hypoxic condition of tissues,and it can also reduce the degree of heart and kidney damage in severely burned patients;2.Traditional monitoring technology guides patients with fluid rehydration In the first 24 hours after the injury,the total fluid replenishment was insufficient,which did not achieve the desired resuscitation effect,and the second 24 hours after the injury was significantly too much;3.The SVRI and EVLWI of patients in the PiCCO group were positively correlated,GEDVI It is positively correlated with CI,GEDVI is not correlated with SVRI,and CI is negatively correlated with SVRI;4.In patients in the PiCCO group at 68 h after injury,the two indicators of SVRI and EVLWI returned to the positive range,and the heart index and other indicators also Return to the normal range,which is the time point when the normal permeability of the blood vessel is completely restored after the burn. |
PDF Full Text Request