肺超声动态监测在重症休克患者容量复苏评估中的应用价值分析  

Application value of pulmonary ultrasound dynamic monitoring in the evaluation of volume resuscitation in patients with severe shock

作　　者：崔建伟[1] 赵炳朕[1] 王林军 Cui Jianwei;Zhao Binglian;Wang Linjun(Department of Intensive Care Medicine,Liangxiang Hospital,Fangshan District,Beijing 102401,China)

机构地区：[1]北京市房山区良乡医院重症医学科,102401

出　　处：《山西医药杂志》2022年第22期2536-2539,共4页Shanxi Medical Journal

摘　　要：目的探讨肺超声动态监测在重症休克患者容量复苏评估中的应用价值。方法选择2020年1月至2022年1月我院重症监护室收治的85例重症休克患者为研究对象,均接受容量复苏等治疗,接受动态肺超声检查及脉搏指数连续心排出量监测技术(PiCCO)监测,比较不同预后患者(存活组和死亡组)肺超声B线数量等指标的差异,以及肺超声B线数量与PiCCO监测血管外肺水指数(EVLWI)的相关性。结果急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分及呼吸机使用时间在存活组患者均明显低于死亡组,差异有统计学意义(P<0.05);在住ICU的第1天、第3天及第5天、第7天,存活组患者的B线数量均明显少于死亡组,差异有统计学意义(P<0.05);且存活组患者的B线数量有逐渐降低的趋势,差异有统计学意义(P<0.05);入住ICU第1天,Pearson相关分析显示,患者的B线数量与EVLWI呈显著正相关(P<0.05)。结论肺超声B线数量与EVLWI具有良好的相关性,肺超声动态监测在重症休克患者容量复苏评估中具有良好的应用价值。Objective To explore the value of dynamic monitoring of pulmonary ultrasound in the evaluation of volume resuscitation in patients with severe shock.Methods Eighty-five patients with severe shock treated in the intensive care unit(ICU)of our hospital from January 2020 to January 2022 were selected as the research objects.They were treated with volume resuscitation,dynamic pulmonary ultrasound and pulse index continuous cardiac output(PiCCO)monitoring.The differences in pulmonary ultrasound B-line number and other indicators in patients with different prognoses(survival group and death group)and the correlation between pulmonary ultrasound B-line number and PiCCO monitoring extravascular lung water index(EVLWI)were compared.Results APACHEⅡscore and ventilator use time in the survival group were significantly lower than those in the death group(P<0.05).On the 1st,3rd,5th and 7th days of living in the ICU,the number of B-line in the survival group was significantly less than that in the death group(P<0.05).The number of B-line in the survival group decreased gradually,and the difference was significant(P<0.05).Pearson correlation analysis showed that there was a significant positive correlation between the number of B-lines and EVLWI on the first day of admission to ICU(P<0.05).Conclusion There is a good correlation between the number of B-lines of pulmonary ultrasound and EVLWI.Dynamic monitoring of pulmonary ultrasound has a good application value in the evaluation of volume resuscitation in patients with severe shock.

关 键 词：肺超声 重症休克 容量复苏 脉搏指数 连续心排量监测技术 

分 类 号：R459.7[医药卫生—急诊医学]