[1]林宗钦,商 益,菅洪健,等.床旁超声评估下腔静脉呼吸变异度联合被动抬腿试验在重症脓毒症休克患者中的应用价值[J].医学信息,2023,36(17):142-145.[doi:10.3969/j.issn.1006-1959.2023.17.029]
　LIN Zong-qin,SHANG Yi,JIAN Hong-jian,et al.Application Value of Bedside Ultrasound in Evaluating Inferior Vena Cava Respiratory Variability Combined with Passive Leg Raising Test in Patients with Severe Septic Shock[J].Journal of Medical Information,2023,36(17):142-145.[doi:10.3969/j.issn.1006-1959.2023.17.029]
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床旁超声评估下腔静脉呼吸变异度联合被动抬腿试验在重症脓毒症休克患者中的应用价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年17期
页码:
142-145
栏目:
论著
出版日期:
2023-09-01

文章信息/Info

Title:
Application Value of Bedside Ultrasound in Evaluating Inferior Vena Cava Respiratory Variability Combined with Passive Leg Raising Test in Patients with Severe Septic Shock
文章编号:
1006-1959（2023）17-0142-04
作者:
林宗钦; 商 益; 菅洪健; 等
（惠州市中大惠亚医院重症医学科，广东 惠州 516081）
Author(s):
LIN Zong-qin; SHANG Yi; JIAN Hong-jian; et al.
(Department of ICU,Hui Ya Hospital of the First Affiliated Hospital,Sun Yat-Sun University,Huizhou 516081,Guangdong,China)
关键词:
脓毒症休克; 下腔静脉呼吸变异度; 床旁超声; 被动抬腿试验; 容量反应性
Keywords:
Septic shock; Inferior vena cava respiratory variability; Bedside ultrasound; Passive leg raising test; Volume responsiveness
分类号:
R459.7；R445.1
DOI:
10.3969/j.issn.1006-1959.2023.17.029
文献标志码:
A
摘要:
目的 探究床旁超声评估下腔静脉呼吸变异度（IVC-RVI）联合被动抬腿试验（PLR）在重症脓毒症休克（SS）患者中的应用价值。方法 选取2019年1月-2022年6月惠州市中大惠亚医院重症医学科收治的64例重症SS患者，所有患者均给予液体负荷试验，依据液体负荷试验后心输出量变化率（△CO），分为VR组（△CO≥10%，n=30）与非VR组（△CO＜10%，n=34），比较两组PLR后CO变化率（PLR-△CO）、IVC-RVI值，分析PLR、IVC-RVI与联合检测对患者容量反应性的预测价值。结果 VR组的PLR-△CO、IVC-RVI值高于非VR组（P＜0.05）；Logistic回归分析显示，PLR-△CO、IVC-RVI均为容量反应性的独立预测因子（P＜0.05）；ROC曲线分析显示，IVC-RVI联合PLR-△CO值预测SS患者容量反应性的灵敏度与特异度大于二者单独检测（P＜0.05）。结论 床旁超声评估IVC-RVI联合PLR对重症SS患者容量反应性具有较高预测价值，可发挥补液指导作用。
Abstract:
Objective To explore the application value of bedside ultrasound assessment of inferior vena cava respiratory variability (IVC-RVI) combined with passive leg raising test (PLR) in patients with severe septic shock (SS).Methods A total of 64 patients with severe SS admitted to the Department of ICU, Hui Ya Hospital of the First Affiliated Hospital, Sun Yat-Sun University from January 2019 to June 2022 were selected. All patients were given fluid load test. According to the change rate of cardiac output (△CO) after fluid load test, they were divided into VR group (△CO≥10%, n=30) and non-VR group (△CO<10%, n=34). The change rate of CO (PLR-△CO) and IVC-RVI values after PLR test were compared between the two groups, and the predictive value of PLR, IVC-RVI and combined detection for volume responsiveness of patients was analyzed.Results The values of PLR-△CO and IVC-RVI in the VR group were higher than those in the non-VR group (P＜0.05). Logistic regression analysis showed that PLR-△CO and IVC-RVI were independent predictors of volume responsiveness (P<0.05). ROC curve analysis showed that the sensitivity and specificity of IVC-RVI combined with PLR-△CO value in predicting volume responsiveness of SS patients were greater than those of the two alone (P<0.05).Conclusion Bedside ultrasound evaluation of IVC-RVI combined with PLR has a high predictive value for volume responsiveness in patients with severe SS, which can play a guiding role in rehydration.

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更新日期/Last Update: 1900-01-01