重症超声指导感染性休克治疗的临床观察

Clinical Observation of Severe Ultrasound Guided Septic Shock Treatment

目的探究重症超声指导感染性休克治疗的临床观察效果。方法选取广东省中山市中医院2015年7月—2017年7月ICU收治的感染性休克患者100例,随机分为观察组及对照组,每组各50例。对照组患者给予连续心排血量监测(PiCCO)监测指导液体复苏,观察组患者给予重症超声监测指导。比较两组患者平均动脉压(MAP)、中心静脉压(CVP)、复苏液体量、6h复苏达标率、ICU入住天数、机械通气时间及28d死亡率,并采用急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)及序贯器官衰竭评分(SOFA)对两组患者治疗前后进行评估比较。结果经治疗后,两组患者APACHEⅡ评分及SOFA评分均较治疗前明显降低(P<0.05),但两组比较差异无统计学意义(P>0.05);两组患者MAP和CVP均较治疗前显著改善(P<0.05),但两组比较差异无统计学意义(P>0.05);两组患者复苏液体量、6h复苏达标率、ICU入住天数、机械通气时间及28d死亡率比较差异无统计学意义(P>0.05)。结论重症超声监测指导感染性休克治疗的疗效显著,有利于促进患者血流动力恢复,减少液体复苏量,提高患者转归结果,值得临床推广应用。

Objective To explore the clinical effect of severe ultrasound in the treatment of septic shock. Methods 100 patients with septic shock admitted to ICU in the hospital from July,2015 to July,2017 were randomly divided into observation group and control group,with 50 cases in each group. Patients in the control group were given continuous cardiac output monitoring(PiCCO)to guide fluid resuscitation,and patients in the observation group were given severe ultrasound monitoring guidance. The mean arterial pressure(MAP),central venous pressure(CVP),volume of resuscitation fluid,6-hour resuscitation rate,ICU stay days,mechanical ventilation time and 28-day mortality rate were compared between the two groups. The patients in the two groups were treated with acute physiology and chronic health score system Ⅱ(APACHE Ⅱ)and sequential organ failure score(SOFA). Evaluation and comparison were conducted before and after treatment. Results After treatment,APACHE Ⅱ score and SOFA score of the two groups were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05);MAP and CVP of the two groups were significantly improved compared with those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05). There were no significant differences in fluid volume,6-hour resuscitation rate,ICU stay days,mechanical ventilation time and 28-day mortality(P>0.05). Conclusion Severe ultrasound monitoring is effective in the treatment of septic shock. It can promote the recovery of blood flow,reduce the volume of fluid resuscitation and improve the outcome of patients. It is worthy of clinical application.