摘要
目的探讨重症超声指导下液体复苏对重症感染性休克患者血流动力学、免疫功能及预后的影响。方法将62例重症感染性休克患者按随机数字法分为重症超声组和对照组,各31例。所有患者均给予感染性休克的常规对症治疗,对照组采取常规液体复苏,重症超声组在重症超声指导下行液体复苏。比较2组血流动力学指标变化,免疫功能及预后情况。结果治疗后6 h、24 h,重症超声组和对照组各血流动力学指标均显著改善,而重症超声组平均动脉压(MAP)、氧合指数(PaO2/FiO2)较对照组明显升高(P<0.05)。治疗后3 d,2组免疫功能指标均明显改善,重症超声组CD4^+、CD4^+/CD8^+、Ig M较对照组明显升高(P<0.05)。与对照组比较,重症超声组机械通气(MV)时间、重症监护病房(ICU)住院时间均明显缩短,24 h输液量及多器官功能障碍综合征(MODS)发生率明显降低(P<0.05)。结论重症超声指导下的液体复苏较常规液体复苏更为有效可行,有利于精准液体管理,促进重症感染性休克患者血流动力学稳定,改善免疫功能和预后。
Objective To explore the effects of fluid resuscitation under the guidance of severe ultrasound on hemodynamics,immune function and prognosis in patients with severe septic shock.Methods Sixty-two patients with severe septic shock were randomly divided into the severe ultrasound group and the control group.All patients were given conventional symptomatic treatment of septic shock,the control group(n=31)was given conventional fluid resuscitation,and the severe ultrasound group(n=31)was given fluid resuscitation under severe ultrasound guidance.Hemodynamic changes,immune function and prognosis were compared between the two groups.Results At 6 h and 24 h after treatment,the hemodynamic indexes of the severe ultrasound group and the control group were significantly improved,and the MAP,PaO2/FiO2 were significantly increased compared with the control group(P<0.05).After 3 days of treatment,the immune function indexes of both groups were significantly improved.CD4^+,CD4^+/CD8^+ and IgM in the severe ultrasound group were significantly higher than those in the control group(P<0.05).Compared with the control group,the MV time and length of stay in ICU in the severe ultrasound group were significantly shortened,and the 24 h infusion volume and the incidence of MODS were significantly reduced(P<0.05).Conclusions Fluid resuscitation under the guidance of severe ultrasound is more effective and feasible than conventional fluid resuscitation,which is conducive to accurate fluid management,promoting hemodynamic stability,and improving immune function and prognosis for severe septic shock.
作者
顾华杰
霍玉洁
樊锐
叶宥文
Gu Huajie;Huo Yujie;Fan Rui;Ye Yewen(Emergency Department,Central Hospital of Yangpu District,(Yangpu Hospital Affiliated to Tongji University),Shanghai200090,China)
出处
《山西医药杂志》
CAS
2020年第15期1949-1952,共4页
Shanxi Medical Journal
关键词
重症超声
休克
脓毒性
液体复苏
免疫功能
预后
Severe ultrasound
Shock
septic
Fluid resuscitation
Immune function
Prognosis
