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目的探讨每搏量变异指导机械通气脓毒症休克患者容量复苏效果。方法 76例脓毒症休克且行机械通气患者,随机分为观察组和对照组,各38例。观察组患者运用每搏量变异指导,对照组则采用中心静脉压监测液体复苏。观察并比较两组患者容量复苏效果。结果观察组治疗24 h后血乳酸水平与急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均明显低于对照组,差异均有统计学意义(P<0.05);两组复苏6 h后的平均动脉压(MAP)和中心静脉血氧饱和度(Scv O2)比较,差异均无统计学意义(P>0.05)。观察组ICU住院时间、机械通气时间、30 d内病死率均显著低于对照组,差异均有统计学意义(P<0.05)。结论每搏量变异监测能更好地指导脓毒症休克行机械通气患者的容量复苏,效果优于传统中心静脉压监测。
Objective To investigate the effect of stroke volume variation on volume resuscitation in patients undergoing mechanical ventilation with septic shock. Methods Seventy - six septic shock patients undergoing mechanical ventilation were randomly divided into observation group and control group, with 38 cases in each group. Patients in the observation group were guided by variations in stroke volume while those in the control group were monitored by central venous pressure. Observed and compared the volume of patients with resuscitation effect. Results After 24 h of treatment, the blood lactate level, acute physiology function and chronic health status score system Ⅱ (APACHEⅡ) scores in observation group were significantly lower than those in control group (P <0.05) The mean arterial pressure (MAP) and central venous oxygen saturation (Scv O2) were not significantly different (P> 0.05). The ICU hospitalization time, mechanical ventilation time and mortality within 30 days in the observation group were significantly lower than those in the control group (P <0.05). Conclusion Stroke variation monitoring can better guide capacity recovery of patients with mechanical ventilation during septic shock, which is superior to traditional central venous pressure monitoring.