重症超声引导下滴定式液体复苏对感染性休克患者血流动力学和炎症因子的影响

Effect of titration liquid resuscitation guided by severe ultrasound on hemodynamics and inflammatory factors in patients with septic shock

目的探讨重症超声引导下滴定式液体复苏对感染性休克患者血流动力学和炎症因子的影响。方法选取2019年1月-2021年1月丰城市人民医院收治的感染性休克患者100例,分为对照组和观察组,每组各50例。对照组采用早期目标导向液体复苏,观察组采用重症超声引导下滴定式液体复苏。对比两组临床结局,对比治疗前后两组血流动力学指标和炎症因子的变化。结果与对照组比较,观察组机械通气时间、ICU入住时间、住院时间及28d病死率明显减少(P<0.05)。与对照组比较,治疗后观察组平均动脉压、中心静脉血氧饱和度、中心静脉压明显升高(P<0.05)。与对照组比较,治疗24h及72h后观察组血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平明显降低(P<0.05)。结论重症超声引导下滴定式液体复苏能有效改善感染性休克患者临床结局,有助于调节血流动力学,降低炎性因子水平。

Objective To investigate the effect of titration fluid resuscitation guided by severe ultrasound on hemodynamics and inflammatory factors in patients with septic shock.Methods A total of 100 septic shock patients admitted to our hospital from January 2019 to January 2021 were selected and divided into a control group and an observation group,with 50 cases in each group.The control group used early goal-oriented fluid resuscitation,and the observation group used titration fluid resuscitation guided by severe ultrasound.The clinical outcomes of the two groups were compared,and the changes of hemodynamic indexes and inflammatory factors in the two groups before and after treatment were compared.Results Compared with the control group,the observation group's mechanical ventilation time,ICU stay time,hospitalization time and 28d mortality rate were significantly reduced(P<0.05).Compared with the control group,the observation group's mean arterial pressure,central venous oxygen saturation,and central venous pressure increased significantly after treatment(P<0.05).Compared with the control group,the observation group's serum interleukin-6(IL-6),interleukin-10(IL-l0),interleukin-1β(IL-1β)and the level of tumor necrosis factor-α(TNF-α)was significantly reduced(P<0.05).Conc lus ion Titration liquid resuscitation under the guidance of severe ultrasound can effectively improve the clinical outcome of patients with septic shock,help regulate hemodynamics,and reduce the level of inflammatory factors.