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中华重症医学电子杂志 ›› 2025, Vol. 11 ›› Issue (04) : 340 -344. doi: 10.3877/cma.j.issn.2096-1537.2025.04.003

专题笔谈

液体反应性与液体管理
薛月川, 隆云()   
  1. 100730 北京,中国医学科学院北京协和医院重症医学科
  • 收稿日期:2024-12-28 出版日期:2025-11-28
  • 通信作者: 隆云
  • 基金资助:
    北京市自然科学青年科学基金项目(7254396); 北京协和医院药理研究中心血管紧张素Ⅱ注射液治疗难治性分布性休克研究(2025140)

Fluid responsiveness and fluid management

Yuechuan Xue, Yun Long()   

  1. Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2024-12-28 Published:2025-11-28
  • Corresponding author: Yun Long
引用本文:

薛月川, 隆云. 液体反应性与液体管理[J/OL]. 中华重症医学电子杂志, 2025, 11(04): 340-344.

Yuechuan Xue, Yun Long. Fluid responsiveness and fluid management[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2025, 11(04): 340-344.

液体治疗贯穿ICU患者整个血流动力学治疗过程。精准的液体治疗策略是实施个体化液体治疗和器官保护的关键。本文立足于液体反应性,阐述以液体反应性为导向的液体治疗策略,通过对机体容量反应性、液体耐受性、血压反应性和灌注反应性的评估,判断液体治疗的有效性、限度和优化时机,从而实现精准的血流动力学液体治疗,筛选出真正能从液体治疗中获益的患者,避免器官功能损伤,促进危重症患者快速恢复。

Fluid therapy runs throughout the hemodynamic treatment process for ICU patients. A precise fluid therapy strategy is key to implement individualized fluid management and organ protection. A fluid therapy approach guided by fluid responsiveness can help assess the effectiveness, limits, and optimal timing of fluid therapy by evaluating the body's volume responsiveness, fluid tolerance, blood pressure responsiveness, and perfusion responsiveness. This approach enables precise hemodynamic fluid management, identifies patients who truly benefit from fluid therapy, avoids organ dysfunction, and promotes the rapid recovery of critically ill patients.

表1 液体反应性内涵、原理、监测指标及优势
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