肺超声动态监测评估重症休克患者容量复苏效果的价值分析

目的探讨肺超声动态监测对评估重症休克患者容量复苏效果的价值。方法选取因休克需要进行容量复苏患者50例,自入住ICU起动态观察左心收缩功能,测定血清BNP水平以评估是否出现心衰,同时观察复苏期间的CVP、血清肌酐及液体平衡情况。结果 50例患者中存活41例,病死9例,共进行床旁心肺超声监测360次。存活患者的肺超声B线阳性切面数在(22.2±4.7)h达到高峰值,最高阳性切面数量为(3.4±0.9)。病死患者的液体正平衡量大,肺超声B线阳性切面数较存活组显著增多(P0.05)。结论容量复苏患者在复苏后期存在容量超负荷现象,肺部超声动态监测B线变化能精确地反映机体的容量变化。

Value of pulmonary ultrasound dynamic monitoring in assessing volume resuscitation effect in patients with severe shock

Objective To explore the value of pulmonary ultrasound dynamic monitoring in assessing volume resuscitation effect in patients with severe shock.Methods A total of 50 shock patients with volume resuscitation were selected,and left cardiac systolic function was monitored dynamically when patients lived in ICU.Serum BNP level was detected to assess whether there was heart failure,and meanwhile the CVP,serum creatinine and fluid balance were observed during the recovery period.Results In the 50 patients,41 patients were survived and 9 patients died,and a total of 360 times of bedside cardiopulmonary ultrasonic monitoring was performed.In the survived patients,the positive number of B line in lung ultrasound reached the peak value at (22.2 ± 4.7) hours,and the highest positive section number was (3.4 ± 0.9).The positive balance of fluid in death patients was large,and the number of positive sections of B line was significantly greater than that of survival group (P ＜ 0.05).Conclusion In patients with volume resuscitation,there is a phenomenon of excess capacity in the late period of volume resuscitation,and the pulmonary ultrasound dynamic monitoring in changes of B line can accurately reflect the changes of body volume.