呼吸末阻断试验评估感染性休克机械通气患者血容量的临床价值研究

发布时间：2018-07-18 07:19

【摘要】：目的研究呼气末阻断试验(EEO)在感染性休克机械通气患者容量反应性中的预测效果,以提高容量反应性评估方法、指导患者血容量复苏。方法选取2013年9月-2015年9月医院重症医学科收治的160例感染性休克机械通气患者临床资料进行分析,采用随机对照方法将患者分为对照组和试验组,每组各80例,对照组为对容量负荷试验无反应性,试验组为对容量负荷试验有反应性,患者入院后对其进行EEO,分析其在感染性休克机械通气患者容量反应性中的预测效果。结果两组患者不同基线下EEO和被动抬腿试验对心率、收缩压、平均血压、舒张压差异无统计学意义;试验组基线1脉压和心脏指数下EEO水平显著高于对照组(P0.05);试验组基线2脉压和心脏指数水平下PLR显著高于对照组(P0.05)。结论感染性休克机械通气患者采用EEO、心脏指数以及脉压等指标均能评估患者容量反应性,而EEO评估容量反应性更加可靠。
[Abstract]:Objective to study the predictive effect of end expiratory blockade test (EEO) on volume reactivity in patients with septic shock during mechanical ventilation, so as to improve the evaluation method of volume reactivity and guide the blood volume resuscitation in patients with septic shock. Methods from September 2013 to September 2015, 160 patients with septic shock mechanical ventilation were analyzed. The patients were divided into control group and experimental group with 80 cases in each group. The patients in the control group were not reactive to the volumetric load test, and the patients in the trial group were treated with EEO after admission. The predictive effect of EEO on volume reactivity in patients with septic shock mechanical ventilation was analyzed. Results there was no significant difference in heart rate, systolic blood pressure, mean blood pressure and diastolic blood pressure between the two groups under different baseline EEO and passive leg lifting test. Baseline 1 pulse pressure and heart index EEO levels in the trial group were significantly higher than those in the control group (P0.05), and PLR at baseline 2 pulse pressure and cardiac index level in the trial group were significantly higher than those in the control group (P0.05). Conclusion EEO, cardiac index and pulse pressure can be used to evaluate the volume reactivity of patients with septic shock, and EEO is more reliable in evaluating volume reactivity.
【作者单位】：海南省人民医院重症医学科;
【基金】：海南省自然科学基金资助项目(814321)
【分类号】：R459.7

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