重症超声联合脉搏指示持续心排血量监测指导急性呼吸窘迫综合征的诊疗效果研究  

Study on the Diagnosis and Treatment Effect of the Severe Ultrasound Combined with Pulse Continuous Cardiac Output in Monitoring of Acute Respiratory Distress Syndrome

作　　者：耿欢 姚玉龙[1] 卢明 雷鸣[1] Geng Huan;Yao Yulong;Lu Ming;Lei Ming(Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《黑龙江科学》2022年第4期88-91,93,共5页Heilongjiang Science

基　　金：上海市浦东新区卫生系统重点学科建设(PWZxk-15)。

摘　　要：分析重症超声联合脉搏指示持续心排血量在监测急性呼吸窘迫综合征患者的临床效果,探讨其在临床诊疗中的应用价值。选取48例急性呼吸窘迫综合征患者将其随机分为对照组和超声组,每组各24例。对照组采用传统的血流动力学监测方法指导其临床治疗,超声组在对照组的基础上采用超声评估指导其临床治疗,记录并比较患者入院及治疗后肺部超声B线积分、血管外肺水(EVLWI)、氧合指数(P/F)、肺血管通透性指数(PVPI)等,并进行相关指标差异及监测结果的相关性统计。两组治疗前的基本情况差异不显著(P>0.05),治疗7 d后,两组患者的病情均有改善(P<0.05),其中肺部超声组在氧合指数、PVPI、住院时间上均显著优于对照组,且Pearson相关性分析发现,治疗前后肺部超声B线积分与APACHE-Ⅱ评分结果、EVLWI水平以及SOFA评分、PVPI均呈现正相关关系(P<0.05);PVPI与氧合指数(P/F)呈负相关关系(P<0.05),与EVLWI水平呈正相关(P<0.05)。通过重症超声联合脉搏指示持续心排血量对急性呼吸窘迫综合征患者进行液体管理治疗,可以改善其临床症状,其中肺部超声指导临床治疗能够缩短患者的住院时间,提高临床疗效,可作为脉搏指示持续心排血量的有效补充手段。The study analyzes the clinical effect of severe ultrasound combined with pulse continuous cardiac output in monitoring of acute respiratory distress syndrome,explores the application value of clinical diagnosis and treatment.48 patients with acute respiratory distress syndrome are randomly divided into control group and ultrasound group,with 24 patients in each group.Control group receive traditional haemodynamics monitoring to guide the clinical diagnosis and treatment,and ultrasound group receive ultrasound evaluation guidance based on control group.Lung ultrasound B line integral,EVLWI,P/F and PVPI after patient’s discharge and treatment are recorded and compared.Differences of related indexes and monitoring results are statistically analyzed.There is no statistically significant difference in basic situation of two groups before intervention(P>0.05).7 days after treatment,the disease situation of two groups both improve(P<0.05).Oxygenation index,PVPI and hospitalization time of lung ultrasound group are significantly better than control group.Pearson correlation analysis finds that there is positive relationship between lung ultrasound B,and APACHE-Ⅱscore results,EVLWI level and SOFA score and PVPI(P<0.05).There is negative relationship between PVPI and P/F(P<0.05),and positive relationship with EVLWI(P<0.05).Severe ultrasound combined with pulse continuous cardiac output in the treatment of liquid management of patients with acute respiratory distress syndrome can improve the clinical symptom.Lung ultrasound guidance of clinical treatment can reduce patient’s hospitalization time,improve clinical effect.It can be used as an effective supplement means of pulse indicator continuous cardiac output.

关 键 词：重症超声 脉搏指示持续心排血量 急性呼吸窘迫综合征 监测指导 

分 类 号：R459.7[医药卫生—急诊医学]