论文部分内容阅读
目的:探讨机械通气联合超声评估脓毒性休克患者容量反应性的价值。方法:采用前瞻性研究,根据制定的纳入及排除标准,纳入2016年10月至2018年2月就诊于新疆医科大学第一附属医院急诊重症监护室的脓毒性休克患者共59例。首先进行呼气末阻断试验(end-expiratory block test,EEO)和吸气末阻断试验(end-inhalation block test,EIO),然后进行容量负荷试验(volume expansion test,VE) (10 min内静滴生理盐水250 mL),VE后心脏指数(cardiac index,CI)变化值(ΔCI)≥15%为容量有反应组(37例),ΔCI0.05)。EEO-ΔSVV、EEO-ΔRVI、EEO-ΔCVP、EIO-ΔSVV及EIO-ΔRVI在容量有反应组与无反应组之间比较,差异有统计学意义(n Pn AUCEIO-ΔSVV>n AUCEIO-ΔRVI>n AUCEEO-ΔCVP。n 结论:EEO及EIO联合超声在脓毒性休克患者容量反应性的评估中有一定的临床应用价值,且SVV、RVI的评估价值优于CVP、MAP、CI。“,”Objective:To evaluate the value of mechanical ventilation combined with ultrasound in evaluating the volume reactivity of patients with septic shock.Methods:A prospective study was performed, and 59 patients with septic shock who were admitted to the Emergency Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from October 2016 to February 2018 were included according to the established inclusion and exclusion criteria. First, end-expiratory block test (EEO) and end-inhalation block test (EIO) were performed, followed by volume expansion test (VE) (intravenous infusion of 250 mL saline for 10 min), with cardiac index (CI) change value after VE (ΔCI)≥15% for volume-responsive group (37 cases), ΔCI0.05). EEO-ΔSVV, EEO-ΔRVI, EEO-ΔCVP, EIO-ΔSVV and EIO-ΔRVI were compared between the reaction group and the non-reaction group, and the difference was statistically significant (n Pn AUCEIO-ΔSVV>n AUCEIO-ΔRVI>n AUCEEO-ΔCVP.n Conclusions:EEO and EIO combined with ultrasound have certain clinical value in the evaluation of volume responsiveness in patients with septic shock, and the evaluation value of SVV and RVI is superior to CVP, MAP, and CI.