基于床旁超声指导下的早期液体复苏治疗对脓毒症休克患者的血清炎症因子、血流动力学指标的影响  

Effect of Early Fluid Resuscitation under the Guidance of Bedside Ultra⁃sound on Serum Inflammatory Factors and Hemodynamic Indexes in Pa⁃tients with Septic Shock

作　　者：王亚楠 黄鲜菊 赵俊芝 WANG Yanan;HUANG Xianju;ZHAO Junzhi(Department of Critical Care Medicine,Cao County People's Hospital,Heze,Shandong,274400,China)

机构地区：[1]曹县人民医院重症医学科,山东菏泽274400

出　　处：《中外医疗》2025年第3期18-22,共5页China & Foreign Medical Treatment

摘　　要：目的 探究床旁超声指导下早期液体复苏对脓毒症休克(septic shock, SS)患者的影响。方法 前瞻性方便选取2021年9月—2023年9月曹县人民医院收治的92例SS患者为研究对象,根据不同治疗方案分为两组,各46例。对照组行中心静脉导管留置液体复苏,观察组于床旁超声指导下早期液体复苏。比较两组炎症因子水平、血流动力学指标与液体复苏量。结果 治疗前,两组患者的炎症因子水平比较,差异无统计学意义(P>0.05)。治疗后12 h,两组患者的炎症因子水平均低于治疗前,且观察组各炎症因子水平均低于对照组,差异均有统计学意义(P均<0.05)。治疗前,两组患者的血流动力学指标比较,差异无统计学意义(P>0.05)。治疗后12 h,两组患者的中心静脉压(central venous pressure, CVP)与平均动脉压(mean arterial pressure, MAP)均高于治疗前,心率(heart rate, HR)均低于治疗前,且观察组患者的MAP与CVP均高于对照组,HR低于对照组,差异均有统计学意义(P均<0.05)。治疗后6 h与12 h,观察组的液体复苏用量分别为(1120.45±136.97)mL、(1 778.95±184.53)mL,少于对照组的(1 539.83±167.53)mL、(2 369.84±200.67)mL,差异均有统计学意义(t=13.144,14.701;P均<0.05)。结论 床旁超声指导下早期液体复苏能够减轻SS患者的炎症反应,调节血流动力学,减少液体复苏用量。Objective To explore the influence of early fluid resuscitation under the guidance of bedside ultrasound on patients with septic shock(SS).Methods A total of 92 SS patients admitted to Cao County People's Hospital from Sep-tember 2021 to September 2023 were prospectively conveniently selected as the research objects.According to differ-ent treatment regimens,they were divided into two groups,with 46 cases in each group.The control group underwent fluid resuscitation with indwelling central venous catheters,while the control group underwent early fluid resuscitation under the guidance of bedside ultrasound.The levels of inflammatory factors,hemodynamic indicators,and the amount of fluid resuscitation were compared between the two groups.Results Before treatment,there was no statistically sig-nificant difference in the levels of inflammatory factors between the two groups(P>0.05).12 h after treatment,the lev-els of inflammatory factors in both groups were lower than those before treatment,and the levels of each inflammatory factor in the observation group were lower than those in the control group,and the differences were statistically signifi-cant(all P<0.05).Before treatment,there was no statistically significant difference in the hemodynamic indicators be-tween the two groups(P>0.05).12 h after treatment,the central venous pressure(CVP)and mean arterial pressure(MAP)of both groups were higher than those before treatment,and the heart rate(HR)was lower than that before treat-ment,the MAP and CVP of the patients in the observation group were higher than those in the control group,and the HR was lower than that in the control group,and the differences were statistically significant(all P<0.05).At 6 h and 12 h after treatment,the amounts of fluid resuscitation in the observation group were(1120.45±136.97)mL and(1778.95±184.53)mL respectively,which were less than those in the control group[(1539.83±167.53)mL and(2369.84±200.67)mL respectively],and the differences were statistically significant(t=13.144,14.701;bot

关 键 词：床旁超声 脓毒症休克 液体复苏 炎症因子水平 血流动力学指标 

分 类 号：R459.7[医药卫生—急诊医学]