目的 探讨补液前实施容量反应性评估对重症肺炎患者预后的影响。方法 回顾性分析2023年1月至2023年12月某三甲医院重症医学科及急诊重症监护室410例诊断为重症肺炎的病例资料。根据补液前是否实施容量反应性评估，将病例分为评估组和对照组，其中实施容量反应性评估的病例纳入评估组，未行容量反应性评估的病例纳入对照组。收集患者性别、年龄、既往史、BMI、急性生理学与慢性健康状况评分系统 Ⅱ(Acute physiology and chronic health evaluation，APACHE Ⅱ)评分等一般资料以及机械通气时间、住院时间、氧合指数、血乳酸、预后等临床资料。通过SPSS 22。0统计学软件对收集的数据进行统计学分析。结果 共纳入410例患者，评估组202例，对照组208例;30天内死亡病例139例;评估组APACH Ⅱ评分(31。13±5。81)与对照组APACH Ⅱ评分(32。03±6。69)相比，差异无统计学意义(P＞0。05);评估组30天住院死亡率(58/202，28。71％)明显低于对照组的死亡率(81/208，38。94％)，差异具有统计学意义(P＜0。05);评估组机械通气时间(9。04±7。97)天短于对照组机械通气时间(10。97±9。07)天(P＜0。05)。结论 补液前实施容量反应性评估可降低重症肺炎患者30天住院死亡率;补液前实施容量反应性评估可缩短患者机械通气时长，降低肺水肿的发生率。
The Impact of Implementing Volume Responsiveness Assessment on the Prognosis of Patients with Severe Pneumonia
Objective To investigate the impact of conducting volume responsiveness assessment before fluid resuscitation on the prognosis of patients with severe pneumonia.Methods From January 2023 to December 2023,a total of 410 cases diagnosed with severe pneumonia in the Intensive Care Unit(ICU)and Emergency Intensive Care Unit(EICU)of a tertiary hospital were collected,based on the inclusion and exclusion criteria.Based on whether the volume responsiveness assessment was conducted,the cases were divided into the assessment group and the con-trol group,with cases undergoing volume responsiveness assessment included in the assessment group and those with-out included in the control group.General information such as patient gender,age,medical history,BMI,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,as well as clinical data including mechanical ventilation time,length of hospital stay,oxygenation index,blood lactate,and 30-day mortality rate,were collected.Statistical analysis was performed using SPSS 22.0 software.Results A total of 410 patients were included,with 202 patients in the evaluation group and 208 patients in the control group;there were 139 cases of death within 30 days.The APACHE Ⅱ scores in the evaluation group(31.13±5.81)were not statistically different from those in the control group(32.03±6.69)(P＞0.05);the 30-day in-hospital mortality rate in the evaluation group(58/202,28.71％)was significantly lower than that in the control group(81/208,38.94％),with a statistically signifi-cant difference(P＜0.05);the duration of mechanical ventilation in the evaluation group(9.04±7.97)days was shorter than that in the control group(10.97+9.07)days(P＜0.05).Conclusion Conducting volume respon-siveness assessment can reduce the 30-day in-hospital mortality rate of patients with severe pneumonia.For surviving patients with severe pneumonia,conducting a volume responsiveness assessment can shorten the duration of mechanical ventilation.
Severe PneumoniaVolume Responsiveness AssessmentMechanical Ventilation Time30-day Mortality Rate
万方数据
维普
