床旁超声技术应用于AKI患者RRT的容量管理中的效果  

Effectiveness of Bedside Ultrasound Technique in Volume Management of RRT in Patients with AKI

作　　者：游丽娜 王典博 赵晓[1] You Lina;Wang Dianbo;Zhao Xiao(Department of Ultrasound,Puyang Oilfield General Hospital,Puyang,Henan,457000,China)

机构地区：[1]濮阳市油田总医院超声科,河南濮阳457000

出　　处：《黑龙江医学》2024年第23期2878-2880,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨床旁超声技术应用于急性肾损伤(AKI)患者连续性肾脏替代治疗(RRT)容量管理中的效果。方法:前瞻性纳入2021年6月—2023年5月于濮阳市油田总医院确诊并接受RRT的39例AKI患者资料,利用计算机生成的随机数字将患者分为对照组(20例)和观察组(19例)。两组患者均接受RRT,对照组患者治疗期间采取中心静脉压(CVP)指导容量管理,观察组患者治疗期间采取床旁超声技术指导容量管理。记录观察组患者治疗前和治疗后30 min、6 h、12 h、36 h、48 h的三尖瓣环收缩期位移(TAPSE)、下腔静脉(IVC)内径、下腔静脉内径呼吸变异度(IVCRVI)以及CVP水平,比较两组患者治疗48 h后心功能[左室射血分数(LVEF)、Tei指数],记录治疗期间低血压发生情况。结果:观察组患者治疗后30 min、6 h、12 h的TAPSE、IVCRVI水平较治疗前升高,IVC内径较治疗前下降,TAPSE、IVCRVI及IVC内径均在治疗后36 h、48 h趋于平稳;各时点TAPSE、IVC内径、IVCRVI水平比较,差异有统计学意义(F=138.896、16.407、149.492,P<0.05);各时点CVP水平比较,差异无统计学意义(F=0.518,P>0.05);治疗48 h后,观察组患者LVEF高于对照组,Tei指数低于对照组,差异有统计学意义(t=8.722、4.349,P<0.05)。观察组患者治疗期间低血压发生率低于对照组,差异有统计学意义(χ^(2)=4.811,P<0.05)。结论:床旁超声技术在AKI患者RRT的容量管理中具有较好的应用效果,可改善患者心功能,降低低血压发生风险。Objective:To investigate the efficacy of bedside ultrasound technology applied in volume management of continuous renal replacement therapy(RRT)in patients with acute kidney injury(AKI).Methods:39 patients with AKI diagnosed and treated with RRT at the hospital from June 2021 to May 2023 were prospectively included and divided into control group(20 patients)and observation group(19 patients)with computer-generated random numbers.Both groups of patients were treated with RRT,and central venous pressure(CVP)was adopted to guide volume management during the treatment of patients in the control group,and bedside ultrasound technology was adopted to guide volume management during the treatment of patients in the observation group.Tricuspid annular systolic displacement(TAPSE),internal diameter of the inferior vena cava(IVC),respiratory variability of the internal diameter of the inferior vena cava(IVCRVI),and CVP levels were recorded in the observation group before treatment,30 min,6 h,12 h,36 h,and 48 h after treatment.Cardiac function[left ventricular ejection fraction(LVEF),Tei index]was compared between the two groups after 48 h of treatment,and the occurrence of hypotension during treatment was recorded.Results:The levels of TAPSE and IVCRVI of patients in the observation group increased 30 min,6 h and 12 h after treatment,and the internal diameter of the IVC decreased compared with that before treatment,while TAPSE,IVCRVI and the internal diameter of the IVC stabilized 36 h and 48 h after treatment.The differences in the levels of TAPSE,IVC inner diameter and IVCRVI at each time point were statistically significant(F=138.896,16.407,149.492;P<0.05),and the differences in the levels of CVP at each time point were not statistically significant(F=0.518,P>0.05).After 48 h of treatment,the LVEF of patients in the observation group was higher than that of the control group,and the Tei index was lower than that of the control group,and the difference was statistically significant(t=8.722,4.349;P<0.05).The incidence of h

关 键 词：急性肾损伤 连续性肾脏替代治疗 床旁超声 中心静脉压 心功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]