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[摘要] 目的 探讨无创血流动力学监测在重型多发伤合并急性呼吸窘迫综合征（ARDS）患者液体复苏中的应用效果。方法 选取2016年1月～2017年1月我院ICU病房收治的重型多发伤合并ARDS患者72例，按随机数字表法分为两组，对照组36例，行常规监护，观察组36例，行无创血流动力学监护，指导液体复苏；比较两组复苏前后心率（HR）、平均动脉压（MAP）、外周血管阻力指数（SVR）、心输出量（CO）、心脏每搏输出量（SV）等体征变化，并比较两组胶体液量、平均输液量、复苏成功率、死亡率及并发症发生率。 结果 观察组复苏后HR、SVR水平低于对照组，MAP、CO、SV水平高于对照组（P<0.05）；观察组胶体液量、平均输液量均低于对照组（P<0.05）；观察组复苏成功率高于对照组，死亡率低于对照组（P<0.05）；观察组并发症发生率低于对照组（P<0.05）。 结论 对重型多发伤合并ARDS患者實施无创血流动力学监测，对液体复苏有良好的指导作用，有利于改善其预后。
[关键词] 重型多发伤；急性呼吸窘迫综合征；无创血流动力学；液体复苏
[中图分类号] R472.2 [文献标识码] B [文章编号] 1673-9701（2017）29-0023-04
Clinical application of noninvasive hemodynamics monitoring in fluid resuscitation in patients with severe multiple trauma complicated with ARDS
WEI Shibo LIU Qingyun
ICU， Hanyang Hospital Affiliated to Wuhan University of Science and Technology， Wuhan 430050， China
[Abstract] Objective To investigate the effect of noninvasive hemodynamics monitoring in fluid resuscitation in patients with severe multiple trauma complicated with acute respiratory distress syndrome（ARDS）. Methods A total of 72 patients with heavy multiple injuries and ARDS in the ICU ward of our hospital from January 2016 to January 2017 were selected. The patients were divided into two groups according to the random number table method. The control group（n=36） was treated with routine monitoring and the observation group（n=36） was treated with noninvasive hemodynamics monitoring to guide the liquid resuscitation. The changes of signs including the heart rate（HR）， mean arterial pressure（MAP）， peripheral vascular resistance index （SVR），cardiac output（CO）and heart stroke volume（SV）between the two groups were compared. And the colloidal fluid volume， the average infusion volume， recovery success rate， mortality and the incidence of complications between the two groups were compared. Results The levels of HR and SVR in the observation group were lower than those in the control group and the levels of MAP， CO and SV in the observation group were higher than those in the control group（P<0.05）. The level of colloid fluid and the average infusion were lower in the observation group than those in the control group（P<0.05）. The success rate of resuscitation in the observation group was higher than that in the control group， and the mortality rate in the observation group was lower than that in the control group（P<0.05）. The incidence of complications in the observation group was lower than that in the control group（P<0.05）. Conclusion Noninvasive hemodynamics monitoring applied in patients with severe multiple trauma and ARDS has a good guiding effect on fluid resuscitation， which is beneficial to improve the prognosis.
[关键词] 重型多发伤；急性呼吸窘迫综合征；无创血流动力学；液体复苏
[中图分类号] R472.2 [文献标识码] B [文章编号] 1673-9701（2017）29-0023-04
Clinical application of noninvasive hemodynamics monitoring in fluid resuscitation in patients with severe multiple trauma complicated with ARDS
WEI Shibo LIU Qingyun
ICU， Hanyang Hospital Affiliated to Wuhan University of Science and Technology， Wuhan 430050， China
[Abstract] Objective To investigate the effect of noninvasive hemodynamics monitoring in fluid resuscitation in patients with severe multiple trauma complicated with acute respiratory distress syndrome（ARDS）. Methods A total of 72 patients with heavy multiple injuries and ARDS in the ICU ward of our hospital from January 2016 to January 2017 were selected. The patients were divided into two groups according to the random number table method. The control group（n=36） was treated with routine monitoring and the observation group（n=36） was treated with noninvasive hemodynamics monitoring to guide the liquid resuscitation. The changes of signs including the heart rate（HR）， mean arterial pressure（MAP）， peripheral vascular resistance index （SVR），cardiac output（CO）and heart stroke volume（SV）between the two groups were compared. And the colloidal fluid volume， the average infusion volume， recovery success rate， mortality and the incidence of complications between the two groups were compared. Results The levels of HR and SVR in the observation group were lower than those in the control group and the levels of MAP， CO and SV in the observation group were higher than those in the control group（P<0.05）. The level of colloid fluid and the average infusion were lower in the observation group than those in the control group（P<0.05）. The success rate of resuscitation in the observation group was higher than that in the control group， and the mortality rate in the observation group was lower than that in the control group（P<0.05）. The incidence of complications in the observation group was lower than that in the control group（P<0.05）. Conclusion Noninvasive hemodynamics monitoring applied in patients with severe multiple trauma and ARDS has a good guiding effect on fluid resuscitation， which is beneficial to improve the prognosis.