摘要
目的:探讨重症超声在感染性休克患者液体复苏的指导价值。方法:选取2018年6月-2019年6月120例我院收的感染性休克患者,采用重症超声指导液体复苏,测量呼气末、吸气末下腔静脉管径(IVC)和左室舒张末期容积(LVEDV),按照公式计算下腔静脉呼吸变异指数(RVI)。水柱法测定中心静脉压(CVP),PiCCO导管法测定血管外肺指数(EVLWI)和胸腔内血容量指数(ITBWI),比较液体复苏前后上述指标,并行相关性分析。结果:复苏后2h、6h感染性休克患者IVC最大径(IVCmax)、IVC最小径(IVCmin)、CVP及LVEDV均较复苏前显著升高,CVP较复苏前显著降低(P<0.05)。复苏后2h、6h感染性休克患者ITBVI、EVLWI均较复苏前显著升高(P<0.05)。IVCmax、IVCmin、LVEDV均与ITBVI、EVLWI呈显著的正相关关系,RVI与ITBVI、EVLWI呈明显的负相关关系(P<0.05)。复苏6h后,感染性休克患者SOFA评分和APACHEⅡ评分均较复苏前显著降低(P<0.05)。结论:重症超声在感染性休克患者的液体复苏过程中发挥重要作用,监测IVC、RVI及LVEDV能够有效评估患者的容量反应性,充分实现液体复苏目标,改善患者病情预后。
Objective:To explore the guiding value of severe ultrasound in fluid resuscitation in patients with septic shock.Methods:From June 2018-June 2019,120 patients with septic shock received in our hospital were selected,and severe ultrasound was used to guide fluid resuscitation,the end-expiratory and end-aspiratory inferior vena cava diameter(IVC)was measured,the index of respiratory variation in inferior vena cava(RVI)was calculated,and the left ventricular end-diastolic volume(LVEDV).Water column method for central venous pressure(CVP),PiCCO catheter method for determination of extravascular lung index(EVLWI)and thoracic content index(ITBWI),the above indexes before and after liquid resuscitation were compared,and the correlation in parallel were analyzed.Results:The IVCmax、IVCmin、CVP and LVEDV of septic shock patients in 2 h,6h after resuscitation were significantly higher than those before resuscitation,CVP significantly lower than those before resuscitation(P<0.05).The ITBVI、EVLWI h,6h septic shock patients after resuscitation were significantly higher than those before resuscitation(P<0.05).IVCmax,IVCmin,LVEDV were positively correlated with ITBVI and EVLWI,RVI was negatively correlated with ITBVI and EVLWI(P<0.05).After 6h of recovery,the SOFA score and APACHEⅡscore of septic shock patients were significantly lower than those before resuscitation(P<0.05).Conclusion:Severe ultrasound plays an important role in the fluid resuscitation of septic shock patients.Monitoring IVC、RVI and LVEDV can effectively evaluate the volume responsiveness of patients,fully achieve the goal of fluid resuscitation,and improve the prognosis of patients.
作者
高明菊
Gao MingJu(Wuhan Hospital of Traditional Chinese Medicine Hanyang District)
出处
《现代科学仪器》
2022年第1期114-118,共5页
Modern Scientific Instruments
关键词
重症超声
感染性休克
液体复苏
指导价值
severe ultrasound
septic shock
fluid resuscitation
guiding value
