摘要
目的:分析重症监护室(Intensive Care Unit,ICU)重症脓毒症患者在床旁超声指导下实施早期液体复苏的临床效果。方法:选取2022年1月至2022年10月本院收治的81例ICU重症脓毒症患者作为研究对象进行回顾性分析,根据液体复苏治疗期间相关指标监测的不同分为观察组(n=42)和对照组(n=39)。对照组在脉搏指示剂持续心排血量法(Pulse indicator Continuous Cardiac Output,PICCO)监测下进行液体复苏,观察组采用床旁超声指导液体复苏。比较两组患者各项生理指标及液体复苏情况,对比肺水肿发生情况及28 d病死率。结果:液体复苏治疗24 h后,两组中心静脉压、平均动脉压、混合静脉血氧饱和度及尿量均明显升高(P<0.05),且观察组明显高于对照组(P<0.05)。观察组液体复苏治疗后各时间点达标率明显高于对照组(P<0.05),液体复苏用量均明显少于对照组(P<0.05)。观察组肺水肿发生率明显低于对照组(P<0.05)。结论:床旁超声检查对ICU重症脓毒症患者早期液体复苏治疗的指导效果优于PICCO检测,能提升液体复苏目标达标率,改善患者各项生理指标。
Objective:To analyze the clinical effects of early fluid resuscitation under the guidance of ultrasound in Intensive Care Unit(ICU)patients with severe sepsis.Methods:A total of 81 patients with severe sepsis in ICU admitted to our hospital from January 2022 to October 2022 were selected as the study objects for retrospective analysis,and according to the monitoring of relevant indicators during fluid resuscitation treatment,they were divided into observation group(n=42)and control group(n=39).The control group underwent fluid resuscitation under the monitoring of Pulse indicator Continuous Cardiac Output(PICCO),while the observation group underwent fluid resuscitation under the guidance of bedside ultrasound.Physiological indexes and fluid resuscitation were compared between the two groups,and the incidence of pulmonary edema and mortality at 28 days were compared.Results:After 24 h of liquid resuscitation treatment,the central venous pressure,mean arterial pressure,mixed venous oxygen saturation and urine volume in the two groups were significantly increased(P<0.05),and the observation group was significantly higher than the control group(P<0.05).The rate of reaching the standard at each time point after liquid resuscitation treatment in the observation group was significantly higher than that in the control group(P<0.05),and the dosage of liquid resuscitation n the observation group was significantly lower than that in the control group(P<0.05).The incidence of pulmonary edema in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Bedside ultrasound is better than PICCO in guiding the early fluid resuscitation treatment of ICU patients with severe sepsis,which can improve the rate of reaching the target of fluid resuscitation and improve the physiological indexes of patients.
作者
祝志刚
郑燕
Zhu Zhi-gang;Zheng Yan(Department of Intensive Care Medicine,Shangrao Municipal Hospital,Shangrao 334000,Jiangxi,China)
出处
《四川生理科学杂志》
2023年第10期1857-1860,共4页
Sichuan Journal of Physiological Sciences
关键词
床旁超声
重症监护室
重症脓毒症
早期液体复苏
Bedside ultrasound
Intensive care unit
Severe sepsis
Early fluid resuscitation
