重症超声在低血容量休克评估及指导临床治疗中的应用研究  

Application of severe ultrasound in the evaluation and guidance of clinical treatment of hypovolemic shock

作　　者：张鸿 赵声龙 谢海涛 徐声馨 马滨 殷应勇 赵杨 黄培娟 黄芸 Zhang Hong;Zhao Sheng-long;Xie Hai-tao;Xu Sheng-xin;Ma Bin;Yin Ying-yong;Zhao Yang;Huang Pei-juan;Huang Yun(Department of Intensive Care Medicine,Zhaotong First People's Hospital,Zhaotong 657000,Yunnan,China;YunnanUniversity of Traditional Chinese Medicine,Kunming 650000,China)

机构地区：[1]昭通市第一人民医院重症医学科,云南昭通657000 [2]云南中医药大学,云南昆明650000

出　　处：《四川生理科学杂志》2022年第7期1133-1135,共3页Sichuan Journal of Physiological Sciences

基　　金：昆明医科大学联合专项-面上项目(编号:202101AY070001-229)。

摘　　要：目的:探讨重症超声在低血容量休克精细化容量管理中的临床价值。方法:选取66例ICU低血容量休克患者随机分成两组,均予常规ICU监测治疗和容量复苏,观察组在重症超声动态评估下予以适时扩容补液-限制性液体复苏-负向液体复苏。观察两组病人6 h、24 h复苏达标率及乳酸清除率差异;比较ICU留置时间及并发肺水肿、多器官功能障碍综合征(Multiple organ dysfunction syndrome,MODS)的差异。结果:两组复苏达标率、乳酸清除率6 h无统计学差异(P>0.05),24 h有统计学差异(P<0.05),且ICU留置时间、并发肺水肿和M0DS例数也有统计学差异(P<0.05)。结论:重症超声可视化动态评估,实现精细化容量管理,指导滴定式治疗,提高复苏达标率和救治效率,缩短ICU留置时间,减少盲目液体复苏并发症。Objective:To investigate the clinical value of intensive ultrasound in fine volume management of hypovolemic shock.Methods:sixty-six patients with hypovolemic shock in ICU were randomly divided into two groups,all of whom received routine ICU monitoring treatment and volume resuscitation,and the observation group received timely dilated-restricted fluid resuscitation and negative fluid resuscitation under the condition of severe ultrasound dynamic assessment.The standard resuscitation rate and lactate clearance rate in 6 hours and 24 hours were observed between the two groups.The difference of ICU induration time,pulmonary edema and Multiple organ dysfunction syndrome(MODS)was compared.Results:There were no significant differences in the resuscitation rate and lactate clearance rate at 6 h(P>0.05),but there were significant differences at 24 h(P<0.05),and there were also significant differences in ICU duration,pulmonary edema and M0DS cases between the two groups(P<0.05).Conclusion:Dynamic visualization of severe ultrasound can realize fine volume management,guide titration treatment,improve the standard resuscitation rate and treatment efficiency,shorten ICU indplacement time,and reduce blind fluid resuscitation complications.

关 键 词：重症超声 休克 液体复苏 评估 治疗 

分 类 号：R47[医药卫生—护理学]