重症超声联合被动抬腿试验对感染性休克患者容量扩张管理的指导价值分析

Value analysis of intensive ultrasound and passive leg raising test in volume expansion management of patients with septic shock

目的分析重症超声联合被动抬腿试验对感染性休克患者容量扩张管理的指导价值。方法选择医院感染性休克患者166例,经被动抬腿管理容量扩张试验后,将患者分成被动抬腿试验预测应答组92例和未应答组74例;比较2组患者测试前、测试时血流动力学变化。结果测试前应答组患者平均动脉压与测试时比较差异无统计学意义(P>0.05),但其心率、两种方式监测的SV值及CO值均明显低于测试时,差异有统计学意义(P<0.05);未应答组患者测试前平均动脉压、心率、两种方式监测的SV值及CO值与测试时比较,差异均无统计学意义(P>0.05);且2组患者超声和PICCO监测SV值、CO值比较差异均无统计学意义(P>0.05)。结论被动抬腿管理容量扩张试验过程联合重症超声监测,能对感染性休克患者的容量扩张进行管理,对患者容量扩张试验具有较好的指导价值,有利于患者液体过度负荷的风险的降低。

Objective To explore the guidance value of intensive ultrasound and passive leg raising test in volume expansion management of patients with septic shock.Methods 166 patients with septic shock were selected in the hospital,after passive leg lifting management capacity expansion test,the patients were divided into passive leg lift test predictive response group 92 cases and non response group 74 cases;The hemodynamic changes were compared between two groups before and during the test.Results Before the test,the mean arterial pressure of the responding group was not significantly different from that during the test(P>0.05);However,the heart rate,the SV value and the CO value monitored by the two methods were significantly lower than during the test,the difference was statistically significant(P<0.05);The mean arterial pressure,heart rate,SV value and CO value of the two methods before and during the test were not statistically significant(P>0.05).There were no significant differences in SV and CO values between ultrasound and PICCO in the two groups(P>0.05).Conclusion The volume expansion test of passive leg lifting management combined with severe ultrasound monitoring can manage the capacity expansion of patients with septic shock,which has a good guiding value for the patient's capacity expansion test and is beneficial to the reduction of the risk of fluid overloading.