肺超声在维持性血液透析患者肺淤血容量评估中的研究进展

Research Progress of Pulmonary Ultrasound in Evaluating Pulmonary Congestion Volume in Maintenance Hemodialysis Patients

维持性血液透析是终末期肾病患者重要的替代治疗方式,而多数终末期肾病血液透患者存在不同程度的液体潴留或隐匿型肺淤血,持续的容量超负荷与患者的死亡率及心血管不良事件密切相关,多种容量评估方法存在缺陷且应用受限,难以发现亚临床肺淤血,因此对血透患者进行容量评估意义重大。近年来,肺超声在透析肺淤血量化评估方面的应用得到关注,其显著的敏感性和半定量评估能力能为患者提供肺部容量信息,不仅能早期发现肺淤血,还能动态观察液体变化并预测透析患者预后,是一种简单、有效且实用的床旁非侵入性手段,其有望联合人工智能为透析患者提供更准确的超滤目标预测和更精细的透析流体管理。

Maintenance hemodialysis is an important alternative treatment for patients with end-stage renal disease,while most patients with hemodialysis of end-stage renal disease have varying degrees of fluid retention or latent pulmonary congestion,and continuous volume overload is closely related to the mortality and cardiovascular adverse events of the patients.Multiple volume assessment methods are defective and limited in application,making it difficult to detect subclinical pulmonary congestion.Therefore,it is important to evaluate the volume of the hemodialysis patients.In recent years,the application of pulmonary ultrasound in the quantitative evaluation of dialysis pulmonary congestion has attracted attention,that its significant sensitivity and semiquantitative evaluation ability can provide the patients with lung volume information,realizing not only the early detection of pulmonary congestion,but also the dynamic observation of the fluid changes topredict the prognosis of the dialysis patients.It is a simple,effective and practical bedside noninvasive means,and is expected to combine artificial intelligence to provide more accurate ultrafiltration target prediction and more refined dialysis fluid management for the dialysis patients.