无创血流动力学监测联合下腔静脉塌陷指数在感染性休克患者补液管理中的应用

Application of non-invasive hemodynamic monitoring combined with inferior vena cava collapse index in fluid management for patients with septic shock

目的探讨无创血流动力学监测联合下腔静脉塌陷指数(IVC-CI)在感染性休克治疗中的应用价值。方法选取2023年1~12月在我院治疗的感染性休克患者60例为研究对象,采用随机数字表法将患者分为观察组和对照组,各30例,对照组给予常规治疗,观察组在对照组治疗基础上给予无创血流动力学监测联合IVC-CI管理,比较两组治疗效果。结果观察组机械通气时间明显短于对照组(P<0.05),液体复苏量、血管活性药物用量、连续性肾脏替代治疗率均明显低于对照组(P<0.05)。观察组治疗后心脏指数(CI)、每搏输出量(SV)和左室射血分数(LVEF)均明显高于对照组(P<0.05),乳酸、降钙素原(PCT)和氨基末端脑钠肽前体(NT-proBNP)均明显低于对照组(P<0.05)。结论无创血流动力学监测联合IVC-CI评估在感染性休克患者补液管理中有较好的应用价值,可缩短机械通气时间,减少液体复苏量和血管活性药物用量,改善心功能,抑制炎症反应,值得临床使用。

Objective To explore the application value of non-invasive hemodynamic monitoring combined with inferior vena cava collapse index(IVC-CI)in the treatment of septic shock.Methods 60 patients with septic shock who were treated in our hospital from Jan to Dec in 2023 were selected and randomly divided into the observation group(n=30)and the control group(n=30)by using random number table method.The control group received routine treatment,while the observation group received non-invasive hemodynamic monitoring combined with IVC-CI management on the basis of the control group.The treatment effects between the two groups were observed.Results Compared with the control group,the mechanical ventilation time of the observation group was significantly shorter(P<0.05).Compared with the control group,the fluid resuscitation volume,dosage of vasoactive drugs and continuous renal replacement therapy rate in the observation group were significantly lower(P<0.05).Compared with the control group,the cardiac index(CI),stroke volume(SV)and left ventricular ejection fraction(LVEF)of the observation group after treatment were significantly higher(P<0.05).Compared with the control group,the levels of lactate,procalcitonin(PCT)and N-terminal proBNP(NT-proBNP)in the observation group after treatment were significantly lower(P<0.05).Conclusion The combination of non-invasive hemodynamic monitoring and IVC-CI can shorten mechanical ventilation time,reduce fluid resuscitation volume and dosage of vasoactive drugs,improve heart function,inhibit inflammatory reactions,which has good application value in fluid management of patients with septic shock.