床旁超声在重症脓毒症患者血流动力学治疗中的应用研究  

Application value of bedside ultrasonography for hemodynamic treatment of patients with severe sepsis

作　　者：许玲[1] 陈健[1] 廖光冲[1] 龙训辉[1] XU Ling;CHEN Jian;LIAO Guang-chong;LONG Xun-hui(Department of Critical Medicine,the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Xinjiang Uygur Autonomous Region Institute of Traditional Chinese Medicine,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区中医药研究院新疆医科大学附属中医医院重症医学科

出　　处：《医疗卫生装备》2020年第1期51-53,69,共4页Chinese Medical Equipment Journal

基　　金：新疆维吾尔自治区自然科学基金面上项目(2017D01C166)

摘　　要：目的:探讨床旁超声在重症脓毒症患者血流动力学治疗中的应用价值。方法:选取2017年9月至2018年12月某院重症医学科收治的重症脓毒症患者52例,随机分为观察组(31例)和对照组(21例)。观察组采用床旁超声监测指导血流动力学治疗,对照组采用传统的监测手段监测指导血流动力学治疗。对比2组治疗前后心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、中心静脉血氧饱和度(ScvO2)、每搏输出量(SV)以及住ICU时间、病死率、去甲肾上腺素使用时间和6 h液体入量差异。采用SPSS 19.0统计学软件进行数据处理。结果:治疗12 h后,2组MAP、CVP、ScvO2和SV值均较治疗前升高(P<0.05),HR值较治疗前降低(P<0.05);治疗12 h后组间比较,观察组MAP、CVP和SV值均高于对照组(P<0.05),HR和ScvO2值组间无统计学差异(P>0.05)。观察组患者住ICU时间、去甲肾上腺素使用时间和6 h液体入量均少于对照组(P<0.01),2组病死率无统计学差异(P>0.05)。结论:床旁超声在重症脓毒症患者血流动力学治疗中具有重要的指导作用,有助于提高脓毒症治疗效果。Objective To explore the application value of the bedside ultrasonography for hemodynamic treatment of the patients with severe sepsis.Methods From September 2017 to December 2018,52 patients with severe sepsis were selected from the department of critical medicine of some hospital,and randomly divided into an observation group(31 cases)and a control group(21 cases).The observation group was given with bedside ultrasound monitoring to guide hemodynamic treatment,while the control group underwent the treatment guided with traditional monitoring method.The two groups were compared over the results before and after the treatment of the heart rate,mean arterial pressure,central venous pressure,central venous oxygen saturation,stroke output,ICU stay time,mortality,duration of noradrenaline use and 6-hour liquid intake were compared before and after treatment.SPSS 19.0 statistical software was used for data processing.Results After 12 hours of treatment,MAP,CVP,ScvO2 and SV values of the two groups were higher than before treatment(P<0.05),and HR value was lower(P<0.05);the observation group had the values of MAP,CVP and SV higher than those in the control group(P<0.05),while the two groups had no significant differences over the values of HR and ScvO2(P>0.05);the observation group had the ICU stay time,duration of noradrenaline use and 6-hour liquid intake lower than those in the control group(P<0.01);the two groups had no statistical difference over the morbidity(P>0.05).Conclusion Bedside ultrasonography is of great significance for the hemodynamic treatment of the patients with severe sepsis.

关 键 词：重症脓毒症 床旁超声 血流动力学 心脏功能 容量反应性 

分 类 号：R318[医药卫生—生物医学工程] R730.41[医药卫生—基础医学]