关键词: 脓毒症, 补液疗法, 超声检查

Abstract: Objective To analyze the clinical effect of bedside ultrasound-guided fluid resuscitation on patients with sepsis in intensive care unit (ICU). 
Methods A total of 97 sepsis patients in ICU of our hospital were selected and randomly divided into observation group (n=49) and control group (n=48) by a random number generation method. Both groups were treated with liquid resuscitation therapy. The control group was given conventional monitoring methods to guide liquid resuscitation, while the observation group was given bedside ultrasound to guide liquid resuscitation based on the control group. The volume of fluid resuscitation was compared between two groups at 6 h and 24 h after treatment. Central venous oxygen saturation (ScvO2), central venous pressure (CVP), mean arterial pressure (MAP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), blood lactate concentration, base residue (BE), oxygen consumption (VO2), and oxygen supply (DO2) levels were compared between two groups before treatment, and at 6 h and 24 h after treatment. The incidence of pulmonary edema, rate of requiring renal replacement therapy, mortality within one month, length of ICU stay, and length of hospital stay were statistically analyzed in both groups. 
Results At 6 h and 24 h after treatment, the amount of fluid resuscitation in the observation group was significantly less than that in the control group, suggesting significant difference (P＜0.05). With the prolongation of treatment time, the levels of ScvO2, CVP, MAP, BE, VO2, and DO2 in both groups showed a gradual upward trend, and the levels of ScvO2, CVP, MAP, BE, VO2, and DO2 in the observation group were higher than those in the control group, with statistically significant differences between groups and time points (P＜0.05). With the prolongation of treatment time, the levels of tumor necrosis factor-α, IL-6 and blood lactic acid gradually decreased, which were lower in the observation group than in the control group, and the differences between groups and time points were statistically significant (P＜0.05). The observation group had shorter ICU stay and hospital stay than the control group, and the rate of requiring renal replacement therapy and the incidence of pulmonary edema were lower than those in the control group, with a statistically significant difference (P＜0.05). There was no significant difference in mortality within one month between two groups (P＞0.05). 
Conclusion Bedside ultrasound-guided fluid resuscitation in patients with sepsis can reduce fluid rehydration volume, inhibit inflammatory reaction, improve hemorheology and oxygen metabolism indicators, and shorten the length of ICU stay, and it plays a positive role in maintaining acid-base balance and promoting patients′ rehabilitation. 

Key words: sepsis, fluid therapy, ultrasonography