首页|超声监测下腔静脉变异度指导液体复苏对脓毒症休克患者血流动力学和预后指标的影响

超声监测下腔静脉变异度指导液体复苏对脓毒症休克患者血流动力学和预后指标的影响

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目的:探讨超声监测下腔静脉变异度指导液体复苏对脓毒症休克患者的血流动力学和预后指标的影响。方法:选取 2020 年 1 月—2023 年 1 月建湖县人民医院收治的 100 例脓毒症休克患者为研究对象,按照随机数表法将其分为对照组和试验组,各 50 例。试验组接受超声监测下腔静脉变异度指导液体复苏治疗,对照组接受常规液体复苏治疗。比较两组复苏前和复苏 72 h后血流动力学指标[平均动脉压(MAP)、中心静脉压(CVP)和乳酸水平]、预后指标[机械通气时间、复苏液体量、重症监护病房(ICU)入住时间、血管活性药物使用时间]、临床指标(6 h复苏达标率、脏器衰竭发生率和 30 d内死亡率)及治疗前和治疗 72 h后急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯性器官衰竭评分表(SOFA)评分。结果:试验组复苏 72 h后乳酸水平低于对照组,MAP和CVP水平高于对照组,机械通气时间、ICU入住时间和血管活性药物使用时间短于对照组,复苏液体量少于对照组,6 h复苏达标率高于对照组,脏器衰竭发生率和 30 d内死亡率低于对照组,治疗 72 h后APACHEⅡ评分和SOFA评分低于对照组,差异有统计学意义(P<0。05)。结论:超声监测下腔静脉变异度指导液体复苏有助于改善脓毒症休克患者血流动力学和预后指标,提高复苏达标率,降低脏器衰竭和死亡发生率,降低APACHEⅡ评分和SOFA评分。
Effect of Ultrasound Monitoring of Inferior Vena Cava Variability Guided Fluid Resuscitation on Hemodynamics and Prognostic Indicators in Patients with Septic Shock
Objective:To explore the effect of ultrasound monitoring of inferior vena cava variability guided fluid resuscitation on hemodynamics and prognostic indicators in patients with septic shock.Method:A total of 100 patients with septic shock who admitted to Jianhu County People's Hospital from January 2020 to January 2023 were selected as the study subjects,they were randomly divided into the control group and the experimental group,with 50 patients in each group.The experimental group was given ultrasound monitoring of inferior vena cava variability guided fluid resuscitation therapy,while the control group was given routine fluid resuscitation therapy.The hemodynamic indexes[mean arterial pressure(MAP),central venous pressure(CVP)and lactic acid level]before resuscitation and 72 h after resuscitation,prognostic indexes[mechanical ventilation time,resuscitation fluid volume,Intensive Care Unit(ICU)stay time,vasoactive drug use time],clinical indexes(6 h resuscitation compliance rate,organ failure rate and 30 d mortality rate),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score and sequential organ failure assessment(SOFA)score before treatment and 72 h after treatment were compared between two groups.Result:The lactic acid level in the experimental group at 72 h after resuscitation was lower than that in the control group,the MAP and CVP levels were higher than those in the control group,the mechanical ventilation time,ICU stay time and vasoactive drug use time were shorter than those in the control group,the resuscitation fluid volume was less than that in the control group,the 6 h resuscitation compliance rate was higher than that in the control group,the incidence of organ failure and 30 d mortality were lower than those in the control group,and the APACHEⅡ score and SOFA score at 72 h after treatment were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Ultrasound monitoring of inferior vena cava variability guided fluid resuscitation in patients with septic shock can help improve hemodynamics and prognostic indicators,improve the recovery rate,reduce the incidence of organ failure and death,and reduce APACHEⅡ score and SOFA score.

Ultrasound monitoring of inferior vena cava variabilityFluid resuscitationSepsis shockPrognostic indicators

陈鹏飞、蒯思、姜伟锋、张振恩

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扬州大学建湖临床医学院 江苏 盐城 224700

超声监测下腔静脉变异度 液体复苏 脓毒症休克 预后指标

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(7)
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