Résumé
The blood-brain barrier (BBB) prevents most therapeutic drugs from entering the brain tissue, which makes diagnosis and treatment of brain diseases difficult, especially diseases of central nervous system. Focused ultrasound can open BBB non-invasively and repeatedly by means of microbubble contrast agents. In recent years, experimental and clinical researches on focused ultrasound treatment of brain diseases have been carried out at home and abroad. The research progresses of focused ultrasound in brain diseases were reviewed in this article.
Résumé
Objective To explore the application effect and nursing methods of pulse indicator continuous cardiac output (PICCO) monitoring technology in large area burn patients. Methods A total of 82 cases of large area burn patients in the hospital from January 2014 to June 2017 were chosen and divided into experimental group (41 cases) and control group (41 cases) by random digits table method. Two groups of patients were treated with the same method, the control group using routine monitoring method to guide liquid resuscitation, the experimental group based on the use of PICCO monitoring technology to guide fluid resuscitation. Hemodynamic indexes, fluid resuscitation time, ICU days, complication rate and mortality rate of the two groups were compared and analyzed. Results After fluid resuscitation, the acute physiology and chronic health system II (APACHE II) score, heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) of the observation group were (18.4 ± 4.2) marks, (98.7±8.5) once/min, (88.5±9.6) mmHg (1 mmHg=0.133 kPa), (10.3±2.5) mmHg.The APACHE II score, HR, MAP and CVP of the control group were (22.7±5.4) marks, (112.5±9.6) once/min, (81.2±10.5) mmHg, (7.9±2.2) mmHg. There were significant differences between the two groups (t=3.285-6.891, all P <0.05). The cardiac index (CI),cardiac output(CO), global end-diastolic volume index (GEDVI), intrathoracic blood volume index(ITBVI), extravascular pulmonary water index(EVLWI) of the observation group after fluid resuscitation were (4.21±0.46) L·min-1·m-2, (4.87±0.52) L/min, (734.51±95.83) ml/m2, (725.91 ± 88.42) ml/m2, (6.26 ± 1.21) ml/kg, respectively. The difference was statistically significant compared to those before fluid resuscitation (t=10.454-21.143, all P <0.05).Resuscitation time and ICU days in the observation group were (3.1±1.2), (31.4±5.8) d. Resuscitation time and ICU days in the control group were (3.9 ± 1.5), (37.8 ± 6.5) d. There were significant differences between the two groups (t=2.667, 4.704, P<0.05). Conclusions PICCO monitoring plays an important role in the early fluid resuscitation in the treatment of large area burn patients, and strengthening the nursing work is beneficial to the targeted treatment and rehabilitation of the patients.