首页|PLR引导的VTI改变联合P(cv-a)CO2在脓毒症休克早期液体复苏应用的临床研究

PLR引导的VTI改变联合P(cv-a)CO2在脓毒症休克早期液体复苏应用的临床研究

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目的 探讨被动抬腿试验(PLR)诱导的主动脉速度-时间积分(VTI)变化联合中心静脉-动脉血二氧化碳分压差(P(cv-a)CO2)与中心静脉压(CVP)监测在严重脓毒血症早期液体复苏中的应用.方法 选自佛山市禅城区中心医院2016年3月~2017年5月期间收治的脓毒症休克患者54例,按照随机数字表法分为治疗组26例与对照组28例.治疗组采用PLR引导的VTI改变联合P(cv-a)CO2,对照组采用CVP监测.比较2组治疗6 h、12 h、24 h的补液量、CVP、BNP和LAC水平变化,及血管活性药物停用时间、机械通气时间、ICU住院时间和死亡发生情况.结果 2组治疗6 h补液量、CVP、BNP和LAC水平比较无统计学差异;治疗组12 h、24 h的补液量、CVP、BNP低于同期对照组(P<0.05),2组的LAC水平比较差异无统计学意义;治疗组血管活性药物停用时间早于对照组,机械通气时间短于对照组,ICU住院时间短于对照组(P<0.05);而2组的28天死亡率比较差异无统计学意义.结论 PLR引导的VTI改变联合P(cv-a)CO2在脓毒症休克早期液体复苏监测中优于CVP,具有重要研究意义.
Study on the use of PLR induced VTI changes combined with P(cv-a)CO2 in sepsis shock early fluid resuscitation
Objective To investigate the use of PLR induced VTI changes combined with P(cv-a)CO2 in sepsis shock early fluid resuscitation. Methods 54 patients with sepsis shock admitted in Chancheng district central hospital from March 2016 to May 2017 were randomly divided into the treatment group (n=26) and the control group (n=28). The treatment group were monitored by the PLR induced VTI changes combined with P(cv-a)CO2, while the control group were monitored by CVP. The changes of 6 h, 12 h, 24 h, CVP, BNP and LAC levels, the time of vasoactive drugs, the time of mechanical ventilation, ICU hospitalization time and mortality were compared between the two groups. Results There were no statistic difference in fluid infusion within 6h, CVP, BNP, and LAC levels in the two groups; Fluid infusion within 12 h and 24 h, CVP and BNP in the treatment group were lower than those in the control group (P<0.05); the two groups for the treatment of 12 h,24 h plasma, LAC levels were no significant difference; The application time of vasoactive drugs, the time of mechanical ventilation and the length of hospitalization in ICU in the treatment group were shorter than those in the control group (P<0.05); The 28 day mortality was not statistically different between the two groups. Conclusion PLR induced VTI changes combined with P (cv-a) CO2 in septic shock early fluid resuscitation monitoring is superior to CVP, which has the important research significance.

passive leg raisingvelocity time integralcentral venous-to-arterial carbon dioxide differencesepsis shockearly fluid resuscitation

娄侠儒、王维策、吴翔、黄响玲

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佛山市禅城区中心医院 重症医学科,广东 佛山 528031

佛山市禅城区中心医院 超声科,广东 佛山 528031

被动抬腿试验 左心室流出道速度时间积分 中心静脉-动脉二氧化碳分压差 脓毒症休克 早期液体复苏

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(9)
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