Department of Critical Care Medicine, Affiliated Hospital of Jiangnan University, Wuxi 214062, China.
Hospitalization Management Section, Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang 157011, China.
J Healthc Eng. 2021 Oct 25;2021:7179632. doi: 10.1155/2021/7179632. eCollection 2021.
The research aimed to study the effect of dexmedetomidine combined with bundle strategy on the cardiac function of patients with severe sepsis through pyramid speckle tracking algorithm-based echocardiography, expected to provide reference for its clinical treatment. 98 patients with severe sepsis or septic shock admitted to the hospital were selected as the research subjects, and they were equally divided into experimental group (dexmedetomidine + bundle strategy) and control group (dexmedetomidine + routine nursing), with 49 in each. Ultrasonic cardiogram examination was performed on patients before and after treatment, and the pyramid-based speckle tracking (PST) algorithm was designed and used. The results showed that the running time of the PST algorithm (105.25 s) was less than that of the BM algorithm (336.41 s), and the difference was statistically significant ( < 0.05), and the systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the experimental group before treatment were not significantly different from those of the control group ( > 0.05). The ultrasound index results found that the ejection fraction (EF) and fractional shortening (FS) of the two groups of patients showed a downward trend over time (1-7 days), while the / ratio showed an upward trend, and the / ratio of the experimental group was significantly greater than the control group ( < 0.05). The systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the two groups of patients showed a downward trend over time (1-7 days), and the systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the experimental group were significantly lower than those of the control group ( < 0.05). The 28-day mechanical ventilation time (6.97 ± 3.11 days), intensive care unit (ICU) stay time (9.18 ± 2.86 days), and the 28-day mortality rate (15.31%) of the experimental group were lower than those of the control group (6.97 ± 3.11 days; 13.08 ± 2.53 days; 31.95%) ( < 0.05). In conclusion, the PST algorithm can effectively improve the quality of echocardiography and assist physicians in clinical evaluation, and dexmedetomidine combined with bundle strategy can stabilize the heart rate and reduce myocardial oxygen consumption in severe sepsis, while effectively shortens the recovery time and improves the overall prognosis.
该研究旨在通过基于金字塔斑点追踪算法的超声心动图研究右美托咪定联合捆绑策略对严重脓毒症患者心功能的影响,为其临床治疗提供参考。选取我院收治的 98 例严重脓毒症或脓毒性休克患者为研究对象,将其均分为实验组(右美托咪定+捆绑策略)和对照组(右美托咪定+常规护理),每组 49 例。对患者治疗前后进行超声心动图检查,设计并使用基于金字塔的斑点追踪(PST)算法。结果显示,PST 算法的运行时间(105.25s)明显短于 BM 算法(336.41s),差异具有统计学意义(<0.05);治疗前实验组患者的收缩压、舒张压、左心室壁、心率与对照组相比差异均无统计学意义(>0.05)。两组患者的超声指标结果发现,心功能 EF 和 FS 随时间呈下降趋势(1-7d),而/呈上升趋势,实验组/比值明显大于对照组(<0.05)。两组患者收缩压、舒张压、左心室壁、心率随时间呈下降趋势(1-7d),实验组收缩压、舒张压、左心室壁、心率明显低于对照组(<0.05)。实验组患者 28d 机械通气时间(6.97±3.11d)、住重症监护病房(ICU)时间(9.18±2.86d)、28d 死亡率(15.31%)均低于对照组(6.97±3.11d;13.08±2.53d;31.95%)(<0.05)。综上所述,PST 算法能有效提高超声心动图质量,辅助医生临床评估,右美托咪定联合捆绑策略能稳定严重脓毒症患者心率,降低心肌耗氧量,有效缩短恢复时间,改善整体预后。