床边超声液体管理在重症妊娠期高血压性心脏病术后的应用  

Application of Fluid Management Based on Bedside Ultrasound on Postoperative in Patients with Severe Gestational Hypertensive During Pregnancy

作　　者：陈真真 李锐 孙召金 CHEN Zhen-zhen;LI Rui;SUN Zhao-jin(The First Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233000;Lu'an Hospital Affiliated to Anhui Medical University,Anhui Lu'an 237000)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000 [2]安徽医科大学附属六安医院,安徽六安237000

出　　处：《深圳中西医结合杂志》2021年第23期92-95,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:分析基于床边超声的液体管理对重症妊娠期高血压(HDCP)性心脏病患者术后血气指标及器官功能的影响。方法:选取2018年1月至2020年3月入住蚌埠医学院第一附属医院重症监护室的29例重症HDCP性心脏病术后患者作为研究对象,将其随机分为对照组13例和观察组16例,对照组采用常规的液体管理方法,观察组采用基于床旁超声的液体管理方法,比较管理后两组患者的血气指标及器官功能。结果:两组患者液体管理3 d后的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)均低于液体管理前,且观察组患者的HR、RR显著低于对照组,差异均具有统计学意义(P<0.05)。两组患者的动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)均显著上升,且观察组患者高于对照组,差异均具有统计学意义(P<0.05)。两组患者液体管理3 d后的序贯器官功能衰竭(SOFA)评分均低于液体管理前,且观察组患者低于对照组,差异具有统计学意义(P<0.05)。结论:基于床旁超声的液体管理可显著改善重症HDCP性心脏病患者术后的生命体征及血气分析结果,减轻器官功能的受损程度。Objective To analyze the effects of fluid management based on bedside ultrasound on postoperative blood gas analysis and organ function in patients with severe gestational hypertensive during pregnancy(HDCP).Methods 29 patients with severe HDCP heart disease admitted to the intensive care unit of the First Affiliated Hospital of Bengbu Medical College from January 2018 to March 2020 were selected as study subjects,and they were randomly divided into control group with13 cases and observation group with 16 cases,the control group used conventional fluid management methods,and the observation group used fluid management methods based on bedside ultrasound,Comparing the blood gas index and organ function of the two groups after management.Results Heart rate(HR),respiratory frequency(RR)and mean arterial pressure(MAP)after 3 day of liquid management in the two groups were lower than before liquid management,and the HR and RR of the observation group were significantly lower than that of the control group(P<0.05).The arterial blood oxygen partial pressure(PaO_(2)),arterial blood carbon 2 partial pressure(PaCO_(2)),oxygenation index(OI)increased significantly in the two groups,and the improvement in the observed group was better than the control group(P<0.05).The sequential organ failure(SOFA)scores of the two groups decreased after 3 days,and the SOFA score of the observation group was lower than that of the control group after 3 days(P<0.05).Conclusion Fluid management based on bedside ultrasound can significantly improve the vital signs and blood gas analysis results of postoperative patients with HDCP,and reduce the degree of damage to organ function.

关 键 词：妊娠期高血压疾病性心脏病 床边超声 液体管理 

分 类 号：R714.246[医药卫生—妇产科学]