中心静脉血氧饱和度联合静动脉二氧化碳分压差监测感染性休克患者液体复苏效果评估

目的 探讨分析中心静脉血氧饱和度联合中心静脉-动脉血二氧化碳分压差对感染性休克液体复苏的指导意义。方法 选取58例感染性休克患者随机分为治疗组和对照组,均在常规治疗的基础上给予体液复苏,对照组患者复苏目标为ScvO₂(中心血氧饱和度)≥0.70,治疗组患者在对照组控制目标的基础上联合Pcv-aCO₂＜6 mmHg,比较两组患者临床效果、治疗前后观察指标,分析复苏6 h后ScvO₂≥0.70的患者Pcv-aCO₂与6 h乳酸清除率相关性。结果 治疗组患者机械通气时间、ICU住院时间较对照组患者显著缩短,6 h平均补液量较对照组患者显著减少,28 d病死率较对照组患者显著降低,治疗后两组患者MAP、CVP、ScvO₂、乳酸清除率、CI、SCr指标水平均显著改善,且治疗组患者观察指标水平改善更显著,差异均具有统计学意义(P＜0.05),复苏6 h后ScvO₂≥0.70的患者Pcv-aCO₂与6 h乳酸清除率呈现负相关(r=-0.754,P＜0.001)。结论 中心静脉血氧饱和度联合中心静脉-动脉血二氧化碳分压差应用于感染性休克患者体液复苏具有重要的指导意义,可有效评价患者的循环血流量,组织灌注状态及缺氧情况。

The significance of central venous oxygen saturation combined with central venous-arterial blood carbon dioxide partial pressure differencein the recovery of septic shock fluid

Objective To explore the significance of central venous oxygen saturation combined with central venous-arterial carbon dioxide partial pressure difference in the recovery of septic shock fluid. Methods To select 58 patients with septic shock were randomly and divide them into treatment group and control group.The patients in the control group were treated with ScvO₂ (central oxygen saturation) ≥0.70.On the basis of the control group,the patients in the treatment group were treated with Pcv-aCO₂＜6 mmHg,The clinical effects of the two groups were compared,and the indexes were observed before and after treatment.The correlation between Pcv-aCO₂ and 6 h lactate clearance was analyzed in patients with ScvO₂≥0.70 after 6h recovery. Results The duration of mechanical ventilation and ICU were significantly shorter in the treatment group than in the control group.The average dosage of 6h was significantly lower than that of the control group.The mortality rate at 28 days was significantly lower than that of the control group.After treatment,MAP,CVP and ScvO₂.The levels of Pcv-aCO₂ in patients with ScvO₂≥0.70 were significantly higher than those in the control group(P＜0.05),and the levels of CI and SCr were significantly improved (r= -0.754,P＜0.001).Conclusion Central venous oxygen saturation combined with central venous-arterial blood carbon dioxide partial pressure difference is an important guideline for the resuscitation of patients with septic shock.It can effectively evaluate the circulatory blood flow,tissue perfusion and hypoxia in patients.