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目的探讨间歇气压治疗(intermittent pneumatic compression,IPC)过程中,气囊充放气时晚期休克患者心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、平均动脉压(mean arterial pressure,MAP)、中心静脉压(central vein pressure,CVP)、脉压(pulse pressure,PP)和呼吸周期中脉压的变化(delta pulse pressure,△PP),预测晚期休克患者对液体复苏的反应性。方法对受试患者分别采用被动抬高下肢试验(passive leg raising,PLR)、IPC和按CVP 2～5原则进行容量负荷试验,观察患者HR、SBP、DBP、MAP、CVP、PP和△PP的变化,评价3种方法在血容量判断中的价值。结果 3种方法均能预测晚期休克患者对液体复苏的反应性,IPC的敏感性为71%,PLR为73%,CVP 2～5原则(补液试验)为83%。补液试验阳性的患者,在IPC时SBP变化为1.5kPa,DBP为0.7kPa,MAP为1.0kPa。结论气压治疗在预防深静脉血栓形成的同时,可以预测晚期休克患者对液体复苏的反应性,指导临床液体复苏治疗。
Objective To investigate the relationship between heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with advanced shock during airway inflation and deflation during intermittent pneumatic compression (IPC) , Mean arterial pressure (MAP), central vein pressure (CVP), pulse pressure (PP) and delta pulse pressure (△ PP) Patient’s response to fluid resuscitation. Methods The patients were tested for passive leg raising (PLR), IPC and volume load according to CVP 2 ~ 5 respectively. The HR, SBP, DBP, MAP, CVP, PP and △ PP Change, evaluate the value of three methods in the determination of blood volume. Results All three methods were able to predict the response to fluid resuscitation in patients with advanced shock. The sensitivities of IPC were 71%, PLR 73% and CVP 2 ~ 5 (rehydration test 83%). Patients with a rehydration test positive had a SBP change of 1.5 kPa at IPC, a DBP of 0.7 kPa and a MAP of 1.0 kPa. Conclusions Air pressure treatment can prevent deep venous thrombosis and predict the reactivity to liquid resuscitation in patients with advanced shock and guide clinical liquid resuscitation.