每搏连续无创血压监测系统指导脓毒症休克患者早期液体复苏的价值OA
Value of continuous non-invasive arterial pressure monitoring system in guiding early fluid resuscitation in patients with septic shock
目的 探究每搏连续无创血压监测系统(CNAP)指导脓毒症休克患者早期液体复苏的价值.方法 采用便利抽样法,选取我院2022年1月—2025年1月收治的80例脓毒症休克患者,使用随机数字表法分别纳入CNAP组、对照组,各40例.2组患者均接受常规治疗,对照组行常规早期液体复苏,CNAP组接受基于CNAP指导的早期液体复苏.对比2组患者液体复苏前后动脉血气、生命体征、电解质、肝肾功能变化,并比较2组预后指标.结果 2组患者复苏达标时、复苏后6 h动脉血pH值、HCO3-均较复苏前升高,血乳酸(Lac)均较复苏前下降(P<0.05).2组患者复苏达标时、复苏后6 h心率(HR)均较复苏前下降,平均动脉压(MAP)、中心静脉压(CVP)、心排量(CO)较复苏前升高(P<0.05).CNAP组患者入住ICU时间短于对照组,并发症发生率较对照组更低,差异均有统计学意义(P<0.05).此外,2组患者复苏前、复苏后6 h血K+、Na+、Cl-比较,差异均无统计学意义(P>0.05);2组患者复苏前、复苏后6 h谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(SCr)比较,差异均无统计学意义(P>0.05).结论 与有创连续血压监测相比,CNAP指导脓毒症休克患者早期液体复苏能够达到相似的血流动力学改善效果,并在达到组织灌注目标的同时发挥降低并发症发生率、缩短患者入住ICU时间的优势.
Objective To investigate the value of continuous non-invasive arterial pressure(CNAP)monitoring system in guiding early fluid resuscitation in patients with septic shock.Methods Using convenience sampling,80 patients with septic shock admitted to our hospital from January 2022 to January 2025 were enrolled and randomly assigned to CNAP and control groups using a random number table,with 40 cases in each group.Both groups received conventional treatment.The control group received conventional early fluid resuscitation,while the CNAP group received early fluid resuscitation guided by CNAP.Changes in arterial blood gas,vital signs,electrolytes,liver and kidney function before and after fluid resuscitation were compared between the two groups,and prognostic indicators were also compared.Results In both groups,arterial blood pH and HCO3-levels at the time of resuscitation target achievement and at 6 hours post-resuscitation were higher than pre-resuscitation levels,while blood lactate(Lac)levels were lower than pre-resuscitation levels,with statistically signifi-cant differences(P<0.05).In both groups,heart rate(HR)at the time of resuscitation target achievement and at 6 hours post-resuscitation decreased compared with pre-resuscitation levels,while mean arterial pressure(MAP),central venous pressure(CVP),and cardiac output(CO)increased compared with pre-resuscitation levels,with differences being statisti-cally significant(P<0.05).The CNAP group had a significantly shorter ICU stay and a lower complication rate than the control group(P<0.05).Furthermore,no statistically significant differences were observed in blood K+,Na+,and Cl-levels between the two groups at pre-resuscitation and 6 hours post-resuscitation(P>0.05);no statistically significant differences were found in alanine aminotransferase(ALT),aspartate aminotransferase(AST),and serum creatinine(SCr)levels between the two groups at pre-resuscitation and 6 hours post-resuscitation(P>0.05).Conclusion Compared with invasive continuous blood pressure monitoring,CNAP-guided early fluid resuscitation in patients with septic shock achieves similar hemodynamic improvement effects and offers the advantages of lowering complication rates and shortening ICU stay while achieving tissue perfusion goals.
花蕾;张霞;陈春;庄新梅;张莉;郭文静;熊爱姣;王茜
新疆医科大学第一附属医院重症医学科,乌鲁木齐 830011新疆医科大学第一附属医院重症医学科,乌鲁木齐 830011新疆医科大学第一附属医院血液病二科,乌鲁木齐 830011新疆医科大学第一附属医院重症医学科,乌鲁木齐 830011新疆医科大学第一附属医院护理部,乌鲁木齐 830011新疆医科大学第一附属医院肿瘤二科,乌鲁木齐 830011新疆医科大学第一附属医院肿瘤二科,乌鲁木齐 830011新疆医科大学第一附属医院肿瘤二科,乌鲁木齐 830011
医药卫生
每搏连续无创血压监测系统脓毒症休克液体复苏血流动力学
Continuous non-invasive arterial pressure monitoring systemSeptic shockFluid resuscitationHemodynamics
《保健医学研究与实践》 2026 (1)
38-44,7
新疆维吾尔自治区自然科学基金资助项目(2022D01C477)吴阶平医学基金会临床科研专项资助基金项目(320.6750.2023-02-3).
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