脓毒性休克容量反应性评估的研究进展

Advances in Volume Responsiveness Assessment for Septic Shock

摘要: 脓毒症是一种发病率和死亡率都较高的疾病，其并发脓毒性休克已成为危重症患者死亡的主要原因。脓毒性休克治疗的一个重要方面是液体复苏，是基于增加心脏前负荷来增加心输出量，从而增加全身灌注并减少器官功能障碍。在液体复苏过程中，有效、及时、准确地评估容量状态及容量反应性十分重要，可以改善患者预后。选择合理有效的血流动力学指标来评估容量状态及其反应性也显得尤为重要，也是临床医生关注的重点。本文对脓毒性休克容量管理的研究进展作一综述，以期为脓毒症患者的容量管理提供参考。

Abstract: Sepsis is a disease with high morbidity and mortality, and its complication, septic shock, has be-come the leading cause of death in critically ill patients. An important aspect of septic shock treat-ment is fluid resuscitation, which is based on increasing cardiac preload to increase cardiac output, thereby increasing systemic perfusion and reducing organ dysfunction. During fluid resuscitation, effective, timely and accurate assessment of volume status and volume responsiveness is important and can improve patient prognosis. Choosing reasonable and effective haemodynamic indexes to assess volume status and its responsiveness is also particularly important and is the focus of clini-cians’ attention. This article provides a review of the research progress of volume management in septic shock, with a view to providing reference for the volume management of septic patients.