摘要
目的探讨被动抬腿试验（PLR）诱导的主动脉速度-时间积分（VTI）变化联合中心静脉－动脉血二氧化碳分压差（P(cv-a)CO2）与中心静脉压（CVP）监测在严重脓毒血症早期液体复苏中的应用。方法选自佛山市禅城区中心医院2016年3月~2017年5月期间收治的脓毒症休克患者54例，按照随机数字表法分为治疗组26例与对照组28例。治疗组采用PLR引导的VTI改变联合P(cv-a)CO2，对照组采用CVP监测。比较2组治疗6h、12h、24h的补液量、CVP、BNP和LAC水平变化，及血管活性药物停用时间、机械通气时间、ICU住院时间和死亡发生情况。结果2组治疗6h补液量、CVP、BNP和LAC水平比较无统计学差异；治疗组12h、24h的补液量、CVP、BNP低于同期对照组（P<0.05），2组的LAC水平比较差异无统计学意义；治疗组血管活性药物停用时间早于对照组，机械通气时间短于对照组，ICU住院时间短于对照组（P<0.05）；而2组的28天死亡率比较差异无统计学意义。结论PLR引导的VTI改变联合P(cv-a)CO2在脓毒症休克早期液体复苏监测中优于CVP，具有重要研究意义。
Objective To investigate the use of PLR induced VTI changes combined with P(cv-a)CO2in sepsis shock early fluid resuscitation.Methods54patients with sepsis shock admitted in Chancheng district central hospital from March2016to May2017were randomly divided intothe treatment group(n=26)and the control group(n=28).The treatment group were monitored by the PLR induced VTI changes combined withP(cv-a)CO2,while the control group were monitored by CVP.The changes of6h,12h,24h,CVP,BNP and LAC levels,the time of vasoactivedrugs,the time of mechanical ventilation,ICU hospitalization time and mortality were compared between the two groups.Results There were nostatistic difference in fluid infusion within6h,CVP,BNP,and LAC levels in the two groups;Fluid infusion within12h and24h,CVP and BNP inthe treatment group were lower than those in the control group(P<0.05);the two groups for the treatment of12h,24h plasma,LAC levels were nosignificant difference;The application time of vasoactive drugs,the time of mechanical ventilation and the length of hospitalization in ICU in thetreatment group were shorter than those in the control group(P<0.05);The28day mortality was not statistically different between the two groups.Conclusion PLR induced VTI changes combined with P(cv-a)CO2in septic shock early fluid resuscitation monitoring is superior to CVP,which hasthe important research significance.
作者
娄侠儒
王维策
吴翔
黄响玲
LOU Xia-ru;WANG Wei-ce;WU Xiang;HUANG Xiang-ling(Department of intensive medicine, Chancheng district central hospital, Foshan 528031, China;Department of ultrasound,Chancheng district central hospital, Foshan 528031, China)
出处
《中国生化药物杂志》
CAS
2017年第9期372-374,共3页
Chinese Journal of Biochemical Pharmaceutics
