中国医学创新2026，Vol.23Issue(25)：6-11,6.DOI:10.3969/j.issn.1674-4985.2026.25.002
无创心排量监测结合重症超声在成人脓毒性休克患者液体复苏中的应用价值
Application Value of Non-invasive Cardiac Output Monitoring Combined with Critical Ultrasound in Fluid Resuscitation of Adult Patients with Septic Shock
摘要
Abstract
Objective:To analyze the application value of non-invasive cardiac output monitoring combined with critical ultrasound in fluid resuscitation of adult patients with septic shock,and to provide clinical evidence for fluid management of adult patients with septic shock.Method:A prospective study was conducted,189 adult patients with septic shock who were admitted to Longyou County People's Hospital from July 2023 to May 2025 were selected and divided into a control group and an observation group according to the random number table method.The control group(n=94)received conventional fluid resuscitation treatment,the observation group(n=95)received fluid resuscitation treatment guided by critical ultrasound on the basis of the control group,and synchronous non-invasive cardiac output monitoring was performed.The fluid resuscitation achievement rate at 6,24,and 72 hours after treatment,hemodynamic indicators[MAP,central venous pressure(CVP),HR]and laboratory indicators[lactate(Lac),procalcitonin(PCT),CRP,PLT,Cr,TBIL]before treatment and after 72 h of treatment,prognosis-related indicators,and the incidence of new-onset multiple organ dysfunction syndrome(MODS)were compared between the two groups.Result:The fluid resuscitation achievement rate of the observation group at 6,24,and 72 hours after treatment were higher than those of the control group(P<0.05).The MAP and CVP of the observation group at 72 h after treatment were higher than those of the control group,and the HR was lower than that of the control group(P<0.05).The Lac,PCT,CRP,Cr and TBIL of the observation group at 72 h after treatment were lower than those of the control group,while PLT was higher than that of the control group(P<0.05).The mechanical ventilation time and ICU length of stay of the observation group were shorter than those of the control group,and the 24 h fluid infusion volume and 24 h norepinephrine dosage were less than those of the control group(P<0.05).The incidence of new-onset MODS of the observation group was lower than that of the control group(P<0.05).Conclusion:The application of non-invasive cardiac output monitoring combined with critical ultrasound in fluid resuscitation of adult patients with septic shock can effectively improve the fluid resuscitation achievement rate,improve the hemodynamic status of patients,reduce inflammatory responses,improve prognosis,and lower the incidence of new-onset MODS.关键词
无创心排量监测/重症超声/成人/脓毒性休克/液体复苏/血流动力学/预后Key words
Non-invasive cardiac output monitoring/Critical ultrasound/Adult/Septic shock/Fluid resuscitation/Hemodynamics/Prognosis分类
医药卫生引用本文复制引用
蔡惠芳,袁灵敏,杨勤..无创心排量监测结合重症超声在成人脓毒性休克患者液体复苏中的应用价值[J].中国医学创新,2026,23(25):6-11,6.基金项目
浙江省医药卫生科技计划项目(2024XY205) （2024XY205）
