小容量负荷主动脉时间速度积分变异率在严重多发伤休克患者液体复苏中的应用

发布时间：2018-02-28 21:03

本文关键词： 小容量负荷主动脉时间速度积分变异率休克液体复苏　出处：《广东医学》2017年03期 　论文类型：期刊论文

【摘要】：目的评价小容量负荷下主动脉时间速度积分变异率指导严重多发伤休克患者液体复苏的应用价值。方法选取严重多发伤休克患者,随机分两组,超声指导组(A组)通过小容量负试验在超声下监测主动脉时间速度积分变异率评估容量反应性指导液体复苏,常规治疗组(B组)根据常规指标进行复苏。比较两组患者复苏前后不同时间生理和实验室指标,72 h复苏液体量、血管活性药物使用时间、机械通气时间、28 d死亡率及住ICU时间。结果共纳入64例患者,完成试验的A组有30例,B组有29例,两组患者一般资料比较差异无统计学意义(P0.05),MAP和CVP在复苏后12、24 h和3 d的值两组差异有统计学意义(P0.05),A组患者的复苏液体量和血管活性药物使用时间、机械通气时间和住ICU时间均少于B组(P0.05)。结论利用小容量负荷主动脉时间速度积分变异率评价严重多发伤休克患者的容量反应性能精确指导液体复苏,减少缩短血管活性药物使用时间及机械通气时间。
[Abstract]:Objective to evaluate the value of aortic time-velocity integral variation rate in guiding fluid resuscitation in patients with severe multiple trauma shock under small volume load. Methods patients with severe multiple trauma shock were randomly divided into two groups. Small volume negative test was used to monitor aortic time-velocity integral variability under ultrasound to evaluate volumetric reactivity to guide fluid resuscitation. The physiological and laboratory indexes before and after resuscitation were compared for 72 h resuscitation liquid volume and the use time of vasoactive drugs in the two groups. Results 64 patients were included in the study. 30 patients in group A and 29 patients in group B had completed the test. There was no significant difference in general data between the two groups. There was no significant difference in the volume of fluid resuscitation and the time of use of vasoactive drugs between the two groups at 12h and 3d after resuscitation. The duration of mechanical ventilation and residence of ICU in group B was less than that in group B. ConclusionTo evaluate the volumetric response performance of patients with severe multiple injury shock and guide fluid resuscitation accurately by using the variation rate of time and velocity integral of small volume load aorta. Reduce the use of vasoactive drugs and mechanical ventilation time.
【作者单位】：东莞市人民医院ICU;
【基金】：东莞市科技计划医疗卫生类科研一般项目(编号:20131051010088)
【分类号】：R459.7

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