| 摘要: |
| 目的 探讨床旁超声对感染性休克患儿容量反应性的指导价值。方法 选取本院2014年10月至2017年10月诊治的感染性休克患儿68例,均行补液治疗,根据反应情况分为两组,对照组患儿37例无反应(每博量增加值＜15%),观察组患儿31例有反应(每博量增加值≥15%),于补液前后行床旁超声检测。结果 补液前组间比较,观察组患儿心率、下腔静脉扩张指数、主动脉峰值流速呼吸变异率、肱动脉最大流速变异率高于对照组(p＜0.05)。观察组患儿平均动脉压、胸腔内血容量指数低于对照组(p＜0.05)。补液后组内比较,观察组患儿心率、下腔静脉扩张指数、主动脉峰值流速呼吸变异率、肱动脉最大流速变异率降低(p＜0.05)。观察组患儿平均动脉压、胸腔内血容量指数增加(p＜0.05)。对照组患儿心率、下腔静脉扩张指数、主动脉峰值流速呼吸变异率、肱动脉最大流速变异率、平均动脉压、胸腔内血容量指数未见明显改变(p＞0.05)。补液后组间比较,两组患儿心率、下腔静脉扩张指数、主动脉峰值流速呼吸变异率、肱动脉最大流速变异率、平均动脉压、胸腔内血容量指数无显著差异(p＞0.05)。结论 床旁超声可用于指导感染性休克患儿的补液治疗。 |
| 关键词: 床旁超声 感染性休克 容量反应性 |
| DOI： |
| 投稿时间：2018-04-13修订日期：2018-05-20 |
| 基金项目: |
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| Observation research of bedside ultrasound on capacity responsiveness in children with septic shockZhang Xuesong1 ,Zhou Qiaolan1 , Qian Qingqiang 2,Kang Yanmin3 |
| zhangxuesong |
| () |
| Abstract: |
| Objective To investigate guiding value of bedside ultrasound on capacity responsiveness in children with septic shock. Methods 68 children with septic shock were selected in hospital from October 2014 to October 2017, who received rehydration treatment. According to reaction condition, children were divided into two groups.37 children had no response (increasing of SV＜15%) as control group.31 children had response (increasing of SV≥15%) as observation group. Bedside ultrasound detected before and after rehydration. Results Compared between two groups before rehydration, heart rate, dilatation index of inferior vena cava, respiratory variation rate of aortic peak flow velocity, maximum velocity variation of brachial artery in observation group were higher than control group (P<0.05). Mean arterial pressure and intrathoracic blood volume index in observation group were lower than control group (P<0.05). Compared intra group after rehydration, heart rate, dilatation index of inferior vena cava, respiratory variation rate of aortic peak flow velocity, maximum velocity variation of brachial artery decreased in observation group(P<0.05). Mean arterial pressure and intrathoracic blood volume index increased in observation group(P<0.05).There were no significant change on heart rate, dilatation index of inferior vena cava, respiratory variation rate of aortic peak flow velocity, maximum velocity variation of brachial artery, mean arterial pressure, intrathoracic blood volume index in control group(P>0.05). Compared between two groups after rehydration, there were no significant difference on heart rate, dilatation index of inferior vena cava, respiratory variation rate of aortic peak flow velocity, maximum velocity variation of brachial artery, mean arterial pressure, intrathoracic blood volume index between two groups(P>0.05). Conclusion Bedside ultrasound can be used to guide fluid replacement therapy in children with septic shock. |
| Key words: Bedside ultrasound Septic shock Volume responsiveness |
