摘要
目的分析心脏超声与脉波指示持续心排血量(pulse indicator continuous cardiac output,PICC0)监测对感染性休克患者抬腿试验后容量反应性的评估价值。方法选取我院2015年11月-2018年6月收治的102例感染性休克患者作为研究对象,患者均在行被动抬腿试验(PLR),同时分别进行超声多普勒检测和PICC0脉搏检测,比较应答及未应答者基础血流动力学和测试前间血流动力学改变情况。结果)02例感染性休克患者中,63例(61.76%)患者对PLR存在反应,39例(38.23%)患者对PLR未存在反应。应答者与未应答者年龄、性别、体重、身高、感染部位、基础MAP、基础CVP、基础HR比较差异无统计学意义(P>0.05);PLR应答者基础血流动力学与测试时血流动力学HR、MAP水平差异无统计学意义(P>0.05);PLR应答者测试时血流动力学CVP、SV-Doppler、SV-PICCO、CO-Doppler、CO-PICCO水平明显高于基础血流动力学,差异有统计学意义(P<0.05);PLR未应答者基础血流动力学与测试时血流动力学HR、MAP、CVP、SV-Doppler、SV-PICCO、CO-Doppler、CO-PICCO水平比较,差异无统计学意义(P>0.05)。结论相对于PICCO,心脏超声具有无创性、检查价格低的优势,并可有效监测感染性休克患者的抬腿试验后容量反应性。
Objective To assess the value of echocardiography and PICCO monitoring in evaluating the volume responsiveness after leg raising test of patients with septic shock.Methods One hundred and two patients with septic shock treated in author′s hospital in November 2015 and June 2018 were selected as the subjects.The patients were all subjected to passive leg lifting test(PLR),and the ultrasonic Doppler detection and PICCO pulse detection were performed respectively.The basic hemodynamic changes and hemodynamic changes in the pretest were compared between the response and unresponders.Results Of the 102 patients with septic shock,63(61.76%)responded to PLR,and 39(38.23%)did not respond to PLR.There was no significant difference in age,sex,weight,height,site of infection,base MAP,base CVP and basic HR between the response and unresponders(P>0.05).There was no significant difference in the level of HR and MAP between the basic hemodynamics and hemodynamics at test time in PLR responders(P >0.05).The CVP,SVDoppler,SV-PICCO,CO-Doppler and CO-PICCO of hemodynamics at the test of PLR responders were significantly higher than those of basic hemodynamics(P<0.05).There was no significant difference in HR,MAP,CVP,SV-Doppler,SV-PICCO,CO-Doppler and CO-PICCO between the basic hemodynamics and hemodynamics at test time of PLR unresponders.Conclusion Compared with PICCO,echocardiography shows an advantage in its non-invasive and low detection price,and it can effectively monitor volume responsiveness after leg raising test in patients with septic shock.
作者
马开香
胡琳璘
Ma Kaixiang;Hu Linlin(Department of Severe Medicine,Jiangbei Hospital ,Affiliated to Southeast University,Nanjing 210044,China)
出处
《中国煤炭工业医学杂志》
2018年第6期608-611,共4页
Chinese Journal of Coal Industry Medicine
基金
江苏省自然科学基金资助项目(编号:BK20150645)
