经胸心脏超声指导感染性休克患者围术期液体复苏的应用效果评估

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Abstract Objective To evaluate the effect of transthoracic echocardiography on perioperative fluid resuscitation in patients with septic shock.Methods From May 2015 to December 2016,64 patients with septic shock requiring surgery in our hospital were selected as the subjects,and divided into study group and reference group by random table number method,32 cases in each group.The reference group was monitored to guide fluid resuscitation by pulse wave indicator continuous cardiac output method (PiCCO),while the study group was monitored by transthoracic echocardiography to guide fluid resuscitation.The heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),fluid volume,urine volume and positive fluid balance were compared between the two groups at 1,2 and 3 h after fluid resuscitation.The dosage of vasoactive drugs,the time of ICU occupancy,the incidence of pulmonary edema and the mortality of 7 d were compared between the two groups.Results At 2 h after resuscitation,the CVP of MAPV in both groups was significantly higher than that in 1 h after resuscitation (P＜0.05).At 2 and 3 h after resuscitation,the resuscitation liquid volume and positive fluid balance in the study group was significantly fewer than that in the reference group.Urine volume in the study group was significantly more than that in the reference group at 2 h after resuscitation,the differences were statistically significant(P＜0.05).There was no significant difference in the dosage of vasoactive drugs between the two groups(P＞0.05).However,the ICU occupancy time,the incidence of pulmonary edema and the mortality of 7 d in the study group were lower than those in the control group,the differences were statistically significant(P＜0.05).Conclusion The application of transthoracic echocardiography can more accurately guide the fluid resuscitation in patients undergoing septic shock surgery.It can reduce complications and is non-invasive.It has significant application effect,which is worthy of further clinical promotion.

Key words： Transthoracic echocardiography Continuous cardiac output monitoring Septic shock Fluid resuscitation

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	Articles by authors
	WEI Hong
	TU Han-kun
	LI Chao-yang
	GAO Yu-lan
	ZHANG Jie
	LUO Xiao-min

Cite this article:

WEI Hong,TU Han-kun,LI Chao-yang, et al. Evaluation of perioperative fluid resuscitation in septic shock patients guided by transthoracic echocardiography[J]. 中国当代医药, 2018, 25(21): 79-81转84.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I21/79

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