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秦瑶, 尹万红, 曾学英, 等. 重症超声在病毒性肺炎患者循环障碍中的应用思考——基于重症超声的新分型与精准治疗[J]. 四川大学学报(医学版), 2021, 52(4): 555-560. DOI: 10.12182/20210360502
引用本文: 秦瑶, 尹万红, 曾学英, 等. 重症超声在病毒性肺炎患者循环障碍中的应用思考——基于重症超声的新分型与精准治疗[J]. 四川大学学报(医学版), 2021, 52(4): 555-560. DOI: 10.12182/20210360502
QIN Yao, YIN Wan-hong, ZENG Xue-ying, et al. Reflections on the Application of Critical Care Ultrasound in Viral Pneumonia Patients with Circulatory Dysfunction—New Classification and Precision Treatment Based on Ciritical Care Ultrasound[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(4): 555-560. DOI: 10.12182/20210360502
Citation: QIN Yao, YIN Wan-hong, ZENG Xue-ying, et al. Reflections on the Application of Critical Care Ultrasound in Viral Pneumonia Patients with Circulatory Dysfunction—New Classification and Precision Treatment Based on Ciritical Care Ultrasound[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(4): 555-560. DOI: 10.12182/20210360502

重症超声在病毒性肺炎患者循环障碍中的应用思考——基于重症超声的新分型与精准治疗

Reflections on the Application of Critical Care Ultrasound in Viral Pneumonia Patients with Circulatory Dysfunction—New Classification and Precision Treatment Based on Ciritical Care Ultrasound

  • 摘要: 病毒是肺部感染的主要病原体之一,易引起大规模流行性病毒性肺炎。重症病毒性肺炎常常会有急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)表现,其表现出的临床症状特殊性,在循环系统尤为明显。重症超声的广泛使用,使我们能够更加深入地认识重症病毒性肺炎的急性循环障碍特征,并加深我们对其他类型感染所致循环障碍的思考。重症病毒肺炎中急性循环障碍并不少见,主要表现为血管受损、容量紊乱和心脏异常,其中心脏异常又可细分为高应激状态、急性右心障碍及弥漫性心脏功能抑制。在前期管理不善等情况下,这些急性循环障碍又可进展为休克,或者直接导致或加重其他脏器功能障碍(如急性肾损伤),加重不良结局。因此,基于重症超声模块化评估进行急性循环障碍分型,将有助于我们推进对急性循环障碍的理解和更深入的研究。

     

    Abstract: Viruses are among the main pathogens of pulmonary infection and tend to cause pandemics of viral pneumonia. Severe viral pneumonia tends to be accompanied by acute respiratory distress syndrome (ARDS) manifestations, displaying highly specific clinical symptoms that are most prominently expressed in the circulatory system. Shock occurred rarely, it occured at a rather late stage in this outbreak of viral pneumonia. However, because of the extensive use of critical care ultrasound, we have a deeper understanding of the characteristics of acute circulatory disorder caused by severe viral pneumonia, prompting us to reflect more thoroughly about circulatory disorders caused by other types of infections. In general, acute circulatory disorder is not uncommon in severe viral pneumonia in this outbreak, and is characterized by vascular damage, volume disorder and cardiac abnormalities of three types, high stress state, acute right ventricular dysfunction and diffuse cardiac inhibition. In the case of poor management in the early stage, these acute circulatory disorders may develop into shock, or directly cause or aggravate other organ dysfunction, for example, acute kidney injury, exacerbating the adverse outcomes. This has allowed us to reflect more thoroughly on the occurrence and development of acute circulatory disorders caused by other infections. Therefore, the classification of acute circulatory disorders based on the modular assessment of critical care ultrasound will help promote better understanding of acute circulatory disorders and further research.

     

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