重症超声在脓毒性休克液体复苏治疗中的研究进展

Research Progress of Severe Ultrasound in the Treatment of Septic Shock Fluid Resuscitation

摘要: 脓毒性休克(septic shock)是重症监护病房常见的一种急危重症，在对患者进行救治时，液体复苏是治疗的核心环节。但传统的基于静态参数的液体复苏策略常不能正确评价患者的容量状态和反应性，容易造成复苏不足或者容量过负荷的情况发生。而重症超声是一种无创且动态的床旁评估手段，可通过对心脏功能、下腔静脉变异度以及肺水的情况来反应对脓毒性休克患者的精细化液体管理。本文就目前重症超声应用在脓毒性休克液体复苏治疗的研究进展进行了综述，着重讨论了重症超声用于评估容量反应性和监测器官灌注、指导液体管理和避免容量过负荷等方面的临床意义并总结了现有研究情况，旨在为临床工作提供借鉴。

Abstract: Septic shock is a common acute and severe disease in intensive care unit. In the treatment of patients, fluid resuscitation is the most important part. Traditional fluid resuscitation strategies based on static parameters often fail to correctly evaluate the patient’s volume status and responsiveness, which is likely to cause insufficient resuscitation or volume overload. Severe ultrasound is a non-invasive and dynamic bedside evaluation method, which can achieve a new idea of precise fluid management for patients with septic shock through cardiac function, inferior vena cava variability and lung water status. This article reviews the research progress of severe ultrasound in the treatment of septic shock fluid resuscitation. The clinical significance of critical ultrasound in evaluating volume responsiveness, monitoring organ perfusion, guiding fluid management and avoiding volume overload was discussed, and the existing research situation was summarized in order to provide reference for clinical work.