脓毒血症病人血流动力学变化与液体负荷反应关系的研究  

Evaluation of Hemodynamic Response to Liquid Load in Patients with Sepsis

作　　者：王云徽[1] 王锦[1] 刘荣[1] 张玮[1] 钱传云[1] 

机构地区：[1]昆明医学院第一附属医院EICU,云南昆明650032

出　　处：《昆明医学院学报》2010年第11期77-79,共3页Journal of Kunming Medical College

基　　金：云南省自然科学基金资助项目(2008ZC120M)

摘　　要：目的在强镇静、镇痛、机械通气条件下对脓毒血症患者进行液体治疗,评估患者HR、MAP、CVP、CO、SV、SVI、SVV等作为液体反应指标的差异以及各指标基础值之间的相关性.方法选择120例脓毒血症患者,按理想体重给予10 mL/kg、20 mL/kg、30 mL/kg万汶注射液,观察上述各项指标变化.结果每搏量变异度(SVV)预测液体反应具有良好的敏感性和特异性.结论血液动力学参数每搏量变异度可以预测危重患者的液体反应,可以作为指导这些患者液体治疗的一个有用指标.Objective On strong sedation and analgesia,adopting fluid resuscitation for treatment of mechanically ventilated（MV）patients with severe sepsis,to evaluate the differences of heart rate（HR）,mean arterial pressure（MAP）,central venous pressure（CVP）.cardiac output（CO）,stroke volume（SV）,stroke volume index（SVI）,stroke volume variability（SVV）as predictors of fluid responsiveness and the correlation among these basic indicators.Methods We selected 120 patients with severe sepsis.According to ideal weight,Voluven were administered to patients at a dose of 10 mL/kg,20 mL/kg,and 30 mL/kg,respectively.Then we observed the changes in hemodynamic parameters mentioned above at the onset of and after quick fluid therapy.Result A SVV value had the better sensitivity and specificity for prediction of fluid responsiveness.Conclusion Hemodynamic parameter SVV can predict fluid responsiveness in critical care patients during fluid resuscitation,and may serve as a useful index for guiding fluid therapy in these patients.

关 键 词：脓毒血症 液体反应 每搏量变异度 

分 类 号：R515.3[医药卫生—内科学]