超声心输出量监测在创伤后低血容量休克中的应用价值

摘要

目的：研究超声心输出量监测（USCOM）在创伤后低血容量休克患者液体复苏中的应用价值。方法回顾性分析46例创伤后低血容量休克患者的临床资料，根据治疗中是否应用USCOM分为常规组和USCOM组，对两组患者24 h乳酸水平≤2 mmol/L的比例、24小时液体平衡情况、并发症情况及病死率做一分析。结果经过积极的抢救治疗，两组患者24小时血乳酸≤2 mmol/L比例及病死率的差异无统计学意义，而USCOM组24小时复苏的液体量及发生肺水肿、MODS、DIC的比例较常规组明显减少。结论USCOM是一项准确、快速、安全、无创的血流动力学监测技术，能够有效的指导液体复苏，但仍存在一定的局限性。%Objective To research the application value of USCOM for patients with hypovolemic shock after trauma.MethodsThe clinical data of 46 patients with hypovolemic shock after trauma was analysised retrospectively. All patients were divided into USCOM group and routine group according to using USCOM or not. Then we compared the ratio of lactic acid≤2 mmol/L after 24 hours, transfusion quantities within 24 hours, the incidence of complications and mortality between the two groups. ResultsThere was statistically signiifcant difference of transfusion quantities within 24 hours and the incidence of complication (pulmonary edema、MODS、DIC) between the two groups after treatment,but the ratio of lactic acid≤2 mmol/L after 24 hours and the mortality were not signiifcantly different. Conclusions USCOM was accurate, rapid, safe and noninvasive, which can guide lfuid resuscitation effectively, but now there was still a certain degree of limitation.