脓毒性休克患儿液体复苏前后肾脏灌注改变的肾脏超声特征
Clinical study of renal perfusion changes by ultrasound in children with septic shock before and afer fluid resuscitation
王泽熙 1刘帅2
作者信息
- 1. 050031 河北省石家庄市,河北省儿童医院神经康复科
- 2. 050031 河北省石家庄市,河北省儿童医院重症医学一科
- 折叠
摘要
目的 探讨肾脏超声在脓毒性休克患儿液体复苏前后肾脏灌注改变的临床特征.方法 以 2021 年 2 月-2022 年 7 月医院收治的脓毒性休克的患儿作为研究对象,将补液试验后床旁超声监测每搏量(stroke volume,SV)增加(△SV)≥12%为容量反应阳性,选取 26 例容量反应阳性的患儿为阳性组和 26 例容量反应阴性的患儿为阴性组.监测患儿液体复苏前和复苏 6h后肾动脉阻力指数(resistive index,RI)和能量多普勒超声(power doppler ultrasound,PDU)半定量评分.结果 两组患儿在液体复苏前RI值和PDU评分差异均无统计学意义(P>0.05);液体复苏 6h后,两组患儿的RI及PDU评分均明显改善,但阳性组患儿改善程度均优于阴性组患儿,差异具有统计学意义(P<0.05).结论 肾脏超声可以对脓毒性休克患儿液体复苏前后肾脏灌注情况做出评估,在临床工作中有一定指导作用.
Abstract
Objective Explore the clinical value of renal ultrasound in assessing changes in renal perfusion before and after fluid resuscitation in children with septic shock.Method Fifty two pediatric patients with septic shock admitted to the hospital from February 2021 to July 2022 were selected as the study subjects.Based on the bedside ultrasound monitoring of whether the increase in stroke volume(SV)(△ SV)≥12%after fluid replacement test,they were divided into volume reaction positive group,volume reaction negative group,and positive group,with 26 cases in each group.Monitor the semi quantitative scores of renal artery resistance index(RI)and power Doppler ultrasound(PDU)before and 6 hours after fluid resuscitation in patients.Results There was no statistically significant difference in RI and PDU scores between the two groups of patients before fluid resuscitation(P>0.05);After 6 hours of fluid resuscitation,the RI and PDU scores of children in the volume response positive group were significantly improved compared to those in the volume response negative group,and the difference was statistically significant(P<0.05).Conclusion Renal ultrasound can evaluate the renal perfusion before and after fluid resuscitation in children with septic shock,and has a certain guiding role in clinical work.
关键词
脓毒性休克/液体复苏/肾脏灌注/容量反应性/肾脏超声Key words
Septic shock/Fluid resuscitation/Renal perfusion/Volumetric reactivity/Renal ultrasound引用本文复制引用
基金项目
河北省2022年度医学科学研究重点课题计划指导性项目(20220742)
出版年
2024
NETL
NSTL
万方数据