肺部超声对休克患者液体管理的临床价值研究

目的:研究肺部超声对休克患者液体管理的临床疗效。方法:选择2016年1月到2018年10月到我院ICU治疗就诊的60例休克患者,按数字表法随机分为实验组和对照组各30例。对照组患者应用中心静脉压(CVP)、平均动脉压(MAP)及尿量对患者进行补液检测治疗,实验组患者应用床旁超声指标对患者进行补液检测治疗。对比两组患者的机械通气时间和ICU住院时间;观察两组患者治疗6h后的MAP、CVP、血乳酸(LAC)、肺水肿发生情况;观察两组治疗1个月后死亡率、复苏液体总量以及尿量。结果:实验组机械通气时间和住院时间明显短于对照组,差异有统计学意义(P0.05);实验组的LAC含量较对照组低,肺水肿发生率较对照组低,差异有统计学意义(P0.05);治疗1个月后,实验组死亡率和复苏液体总量较对照组明显将低,尿量明显增加,差异有统计学意义(P0.05)。结论:床边重症肺部超声技术对提高休克病人的抢救成功率,减少伤残率,提高危重患者生活质量有显著的效果。

Study on the Clinical Value of Pulmonary Ultrasound in Liquid Management in Patients with Shock

ABSTRACT Objective: To study the clinical effect of pulmonary ultrasound on fluid management in patients with shock. Methods: From January 2016 to October 2018, 60 patients with shock who came to ICU of our hospital for treatment were randomly divided into experimental group and control group with 30 cases in each group. The patients in the control group were treated with CVP, MAP and urine volume while bedside ultrasound was used in the experimental group. The mechanical ventilation time and ICU hospitalization time of the two groups were compared; the MAP, CVP, LAC and pulmonary edema of the two groups were observed after 6h of treatment; the mortality rate, total resuscitation fluid and urine volume of the two groups after 1 month of treatment were observed. Results: The mechanical ventilation time and ICU hospitalization time in the experimental group were significantly shorter than that in the control group, with statistical significance(P<0.05); the LAC content in the experimental group was lower than that in the control group, and the incidence of pulmonary edema was lower than that in the control group, with statistical significance (P<0.05); after 1 month of treatment, the mortality rate and total resuscitation fluid in the experimental group were significantly lower than that in the control group, and the urine volume was significantly increased, with statistical significance(P<0.05). Conclusion: Bedside critical pulmonary ultrasound has significant effect on improving the rescue success rate, reducing the disability rate and improving the quality of life of critical patients.