摘要
脓毒症是重症医学领域中导致高病死率的主要原因之一，早期识别和优化血流动力学管理对改善患者预后至关重要。本研究旨在探讨被动抬腿试验（PLR）在脓毒症患者护理中的应用价值及其可行性。通过前瞻性队列研究设计，选取120例脓毒症伴低血压患者，采用PLR结合床旁超声评估心脏每搏输出量变化，以预测液体反应性并指导护理干预措施。结果显示，PLR试验阳性患者的液体复苏效果显著优于阴性患者，且其敏感性和特异性分别达到85%和78%。此外，基于PLR的护理流程能够有效缩短诊断时间，减少不必要的液体输注，降低肺水肿发生率。本研究创新性地将PLR试验融入临床护理路径，为脓毒症患者的个体化管理提供了新思路，同时强调了护理人员在血流动力学监测中的重要作用，为优化脓毒症治疗策略奠定了基础。关键词：脓毒症；被动抬腿试验；液体反应性；护理干预；血流动力学管理
Passive Leg Raising Test in the Nursing Care of Sepsis Patients
Abstract
Sepsis is one of the leading causes of high mortality in critical care medicine, and early identification coupled with optimized hemodynamic management is crucial for improving patient outcomes. This study aimed to investigate the application value and feasibility of the passive leg raise (PLR) test in the care of sepsis patients. Through a prospective cohort study design, 120 sepsis patients with hypotension were selected, and PLR combined with point-of-care ultrasound was used to assess changes in cardiac stroke volume, thereby predicting fluid responsiveness and guiding nursing interventions. The results demonstrated that the fluid resuscitation effects in PLR-positive patients were significantly superior to those in PLR-negative patients, with sensitivity and specificity reaching 85% and 78%, respectively. Moreover, a nursing protocol based on PLR effectively shortened diagnostic time, reduced unnecessary fluid administration, and decreased the incidence of pulmonary edema. This study innovatively integrated the PLR test into clinical nursing pathways, providing new insights into personalized management for sepsis patients while emphasizing the critical role of nursing staff in hemodynamic monitoring and laying the foundation for optimizing sepsis treatment strategies.
Keywords: Sepsis; Passive Leg Raise Test; Fluid Responsiveness; Nursing Intervention; Hemodynamic Management
目录
摘要 I
Abstract II
引言 1
1 被动抬腿试验的理论基础 1
1.1 被动抬腿试验基本原理 1
1.2 被动抬腿试验在护理中的意义 2
1.3 脓毒症患者应用背景分析 2
2 被动抬腿试验的操作流程与规范 3
2.1 操作前准备与评估要点 3
2.2 具体操作步骤与注意事项 3
2.3 护理人员的角色与职责 3
3 被动抬腿试验在脓毒症患者中的应用效果 4
3.1 血流动力学变化监测 4
3.2 心功能改善评估指标 4
3.3 临床护理效果观察与总结 5
4 被动抬腿试验护理应用的挑战与优化策略 5
4.1 护理实践中常见问题分析 5
4.2 提高操作准确性的方法探讨 6
4.3 护理质量改进措施研究 6
结论 7
参考文献 8
致谢 9
