超声心动图六步评估法在感染性休克监护中的应用  

Application of Six Step Evaluation Methods in the Monitoring of Septic Shock

作　　者：孙红杰[1] 张丽[2] 丛树国[2] 苏善道 王慧玲[2] 

机构地区：[1]大庆市人民医院功能科,黑龙江大庆163316 [2]大庆油田总医院重症医学科,黑龙江大庆163311

出　　处：《中国卫生标准管理》2016年第22期158-160,共3页China Health Standard Management

摘　　要：目的探讨超声心动图六步评估法在感染性休克监护中的应用及临床意义。方法选择2012年8月-2016年4月大庆市人民医院及大庆油田总医院重症监护室采用超声心动图六步评估法监测的感染性休克患者35例并纳入观察组,同期重症监护室的常规监护感染性休克患者35例作为对照组。比较两组患者病情缓解情况、液体入量及生化指标。结果两组6 h病情缓解率相似（P〉0.05）,24 h时观察组病情缓解率高于对照组（P〈0.05）。观察组24 h液体用量及1周液体用量均低于对照组（P〈0.05）。两组心肌抑制发生率结果相似（P〉0.05）,但观察组心肌抑制发生时间短于对照组（P〈0.05）,1周后血中心肌肌钙蛋白、降钙素原低于对照组（P〈0.05）。两组1周内肺水肿发生率及ICU病死率差异无统计学意义（P〉0.05）。结论超声心动图可尽早发现心肌抑制,系统分析患者体液反应,指导临床更积极的治疗,利于患者病情缓解。Objective To investigate the application and clinical significance of the six step evaluation methods in the monitoring of septic shock. Methods Total of 35 patients with septic shock by echocardiography and six step evaluation methods for monitoring from August 2012 to April 2016 in Daqing People＇s Hospital and Daqing Oilfield General Hospital of ICU were included in the observation group,35 cases in routine monitoring period of ICU patients with septic shock as control group. Comparison of two groups of patients with disease remission,liquid intake and biochemical indicators. Results 6 h remission rate in the two groups was similar（P〉0.05）. 24 h remission rate of the observation group was higher than that in the control group（P〈0.05）. In observation group,the dosage of 24 h liquid and liquid dosage of 1 weeks were lower than that of control group（P〈0.05）. Two groups of myocardial depression incidence were similar（P〉0.05）,but the observation group myocardial suppression time is shorter than the control group（P〈0.05）,1 weeks after the serum cardiac troponin,procalcitonin is lower than that of the control group（P〈0.05）. There was little difference in the incidence of pulmonary edema and ICU mortality rate between the two groups（P〉0.05） within 1 weeks. Conclusion Echocardiography can be found as soon as possible myocardial depression,systematic analysis of humoral responses,to guide the clinical treatment more positive,beneficial to patients in remission.

关 键 词：感染性休克 超声心动图 六步评估法 监护 

分 类 号：R445.1[医药卫生—影像医学与核医学]