重症超声指导下血流动力学治疗在重症肺炎患者治疗中的应用效果分析

Application Effect Analysis of Critical Care Ultrasound Guided Hemodynamic Treatment in Patients with Severe Pneumonia

目的:分析重症超声指导下血流动力学治疗在重症肺炎患者治疗中的应用效果。方法:选取2019年10月—2022年10月广元市中心医院收治的120例重症肺炎患者作为研究对象,通过随机数字表法分为常规组和重症超声组,各60例。常规组实施常规监测下血流动力学治疗,重症超声组实施重症超声指导下血流动力学治疗。比较两组液体复苏量、液体正平衡量、尿量、乳酸水平、肺水肿发生情况。结果:两组液体复苏量、液体正平衡量比较,治疗6 h<治疗24 h<治疗48 h<治疗72 h,但重症超声组少于常规组,差异有统计学意义(P<0.001)。两组尿量比较,治疗6 h<治疗24 h<治疗48 h<治疗72 h,且重症超声组多于常规组,差异有统计学意义(P<0.001)。治疗后,两组乳酸水平低于治疗前,且重症超声组低于常规组,差异有统计学意义(P<0.001)。重症超声组肺水肿发生率低于常规组,差异有统计学意义(P=0.028)。结论:重症超声指导下血流动力学治疗在重症肺炎患者治疗中的应用效果显著,可改善液体复苏量、液体正平衡量、尿量,纠正乳酸水平,预防肺水肿。

Objective:To analyze the application effect of critical care ultrasound guided hemodynamic treatment in patients with severe pneumonia.Methods:A total of 120 patients with severe pneumonia admitted to Guangyuan Central Hospital from October 2019 to October 2022 were selected as the study subjects.They were divided into conventional group and critical care ultrasound group according to random number table method,with 60 cases in each group.The conventional group received hemodynamic treatment under conventional monitoring and the critical care ultrasound group received hemodynamic treatment under critical care ultrasound guidance.The fluid resuscitation volume,positive fluid balance,urine output,lactic acid levels and pulmonary edema occurrence were compared between two groups.Results:The fluid resuscitation volume and positive fluid balance in the two groups were compared and ranked as follows:6 h of treatment<24 h of treatment<48 h of treatment<72 h of treatment,but these indicators in critical care ultrasound group were less than those in conventional group,and the difference was statistically significant(P<0.001).The urine output in the two groups was compared and ranked as follows:6 h of treatment<24 h of treatment<48 h of treatment<72 h of treatment,but this indicator in critical care ultrasound group was higher than that in conventional group,and the difference was statistically significant(P<0.001).After treatment,the lactic acid levels in the two groups were lower than those before treatment,and the levels in critical care ultrasound group were lower than those in conventional group,and the difference was statistically significant(P<0.001).The incidence of pulmonary edema in critical care ultrasound group was lower than that in conventional group,and the difference was statistically significant(P=0.028).Conclusion:Hemodynamic treatment under critical care ultrasound guidance has a significant effect in the treatment of patients with severe pneumonia,and can improve fluid resuscitation volume,positive fluid balance and urine output,correct lactic acid levels,and prevent pulmonary edema.