被动抬腿联合心脏超声预测容量反应性的临床研究

发布时间：2018-02-08 16:26

  本文关键词： 补液疗法 每博输出量 被动抬腿试验 心脏超声 容量反应性　出处：《重庆医学》2016年26期 　论文类型：期刊论文

【摘要】：目的探讨被动抬腿试验(PLR)联合超声检测心输出量(CO)方法对老年休克患者容量反应性预测的可行性。方法采取前瞻性观察研究方法,选择万州区第五人民医院ICU 2013年1月至2015年9月老年休克患者38例,先后行PLR及补液疗法。按补液疗法后超声检测CO增加百分比大于或等于10%为对容量治疗有反应组,否则为无反应组。结果 38例患者行45例次补液疗法,有反应组13例,无反应组32例。有反应组PLR及补液后CO明显增加(P0.05),两组数值△COPLR为(8.36±4.02)%,ΔCO补液为(8.59±3.53)%;观察有反应组ΔCOPLR与ΔCO补液两组变量呈正相关(r=0.815,P=0.01)。ΔCOPLR预测容量反应性的AUC值为0.854。当阈值ΔCOPLR≥15%时,预测容量反应性敏感性87%,特异性91%。结论 PLR联合超声对CO检测可有效预测容量反应性,可作为一种无创方法指导老年患者休克治疗。
[Abstract]:Objective to investigate the feasibility of passive leg lifting test (PLR) combined with echocardiography in the prediction of volumetric reactivity in elderly patients with shock. 38 elderly patients with shock from January 2013 to September 2015 in 5th people's Hospital of Wanzhou District were treated with PLR and rehydration therapy. The percentage of CO increase detected by ultrasound after fluid resuscitation was greater than or equal to 10% as the group with response to volume therapy. Results Thirty eight patients were treated with 45 times of rehydration therapy, and 13 cases in the response group. In the non-response group, PLR and CO increased significantly (P 0.05), the COPLR values of the two groups were 8.36 卤4.02 and 8.59 卤3.53.The positive correlation was observed between 螖 COPLR and 螖 CO rehydration, and the AUC value of 螖 COPLR was 0.854 when the threshold value of 螖 COPLR 鈮，

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