比较床旁超声和CVP监测下早期液体复苏治疗对脓毒症休克患者的影响

Comparison of the Effect of Early Fluid Resuscitation Therapy under Bedside Ultrasound and CVP Monitoring in Sepsis Shock Patients

目的:比较床旁超声和中心静脉压(CVP)监测下早期液体复苏治疗对脓毒症休克患者的影响。方法:选择2019年1月—2022年12月福清市医院重症医学科收治的80例脓毒症休克患者,随机分为两组,各40例。两组均实施早期液体复苏治疗,观察组在床旁超声监测下治疗,对照组在CVP监测下治疗。比较两组血流动力学指标、乳酸(LAC)水平。结果:治疗前,两组血流动力学指标比较,差异无统计学意义(P>0.05);治疗6 h后,两组心率(HR)低于治疗前,平均动脉压(MAP)、CVP均高于治疗前,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。治疗前,两组LAC比较,差异无统计学意义(P>0.05);治疗6 h后,观察组LAC低于对照组,乳酸清除率高于对照组,差异有统计学意义(P<0.05)。结论:床旁超声和CVP监测下早期液体复苏治疗对脓毒症休克患者血流动力学指标无明显差异,但床旁超声监测下更利于改善LAC水平,且能实时监测超声参数的变化。

Objective:To compare the effects of early fluid resuscitation therapy under bedside ultrasound and central venous pressure(CVP)monitoring on sepsis shock patients.Method:A total of 80 patients with sepsis shock admitted to the Intensive Care Department of Fuqing City Hospital from January 2019 to December 2022 were randomly divided into two groups,with 40 cases in each group.Both groups were treated with early fluid resuscitation,the observation group was treated under bedside ultrasound monitoring,and the control group was treated under CVP monitoring.Hemodynamic indexes and lactic acid(LAC)levels were compared between the two groups.Result:Before treatment,there were no significant differences in hemodynamic indexes between the two groups(P>0.05).After 6 h of treatment,heart rate(HR)in both groups were lower than those before treatment,and mean arterial pressure(MAP)and CVP were higher than those before treatment,the differences were statistically significant(P<0.05);but there were no statistical differences between the two groups(P>0.05).Before treatment,there was no significant difference in LAC between the two groups(P>0.05).After 6 h of treatment,LAC in observation group was lower than control group,lactic acid clearance rate was higher than control group,and the differences were statistically significant(P<0.05).Conclusion:Early fluid resuscitation under bedside ultrasound and CVP monitoring had no significant difference in hemodynamic indexes of sepsis shock patients,but bedside ultrasound monitoring was more conducive to improving LAC levels and real-time monitoring of ultrasonic parameters.