感染性休克患者中心静脉-动脉二氧化碳分压差监测的价值研究

目的 探讨中心静脉-动脉血二氧化碳分压差在反映感染性休克患者全身组织灌注的价值.方法 对2011年3月至2013年5月在我院住院治疗的108例感染性休克患者进行回顾性研究,以P （cv-a）CO2值6mmHg为临界值,分成低P（cv-a）CO2组和高P（cv-a）CO2组,低P（cv-a）CO2组为58例,高P（cv-a）CO2组为50例,入选时定为0点,同时测定复苏6h两组患者MAP、心率、A-PACHEⅡ评分、CVP、乳酸、ScvO2及CI.结果 两组患者MAP、心率、APACHEⅡ评分、CVP、ScvO2、乳酸及CI治疗前后比较,差异有统计学意义（P＜0.05）；治疗后低P（cv-a）CO2组CVP、ScvO2及CI明显高于高P（cv-a）CO2组,两组相比差异有统计学意义（P＜0.05）.结论 P（cv-a）CO2监测对于感染性休克患者全身组织灌注复苏有重要的意义,可以有效地判断患者组织灌注及疾病严重程度,值得临床推广应用.

Study on Central Venous-to-Areterial Blood Carbon Dioxide Partial Pressure Difference in Patients with Septic Shock

Objective To investigate the value of central venous-arterial carbon dioxide partial pressure for systemic tissue perfusion in patients with septic shock. Methods 108 patients with septic shock treated in our hospital from March 2011 to May 2013 were selected and divided into low P（cv-a）CO2 group （/z = 58） and high P（cv-a）CO2 group （n = 50） according to the P（cv-a）CO2 value （critical value of 6 mm Hg）. The MAP, heart rate, APACHE l/ score, CVP, lactate, ScvO2 and CI at 6 h after anabiosis were detected. Results MAP, heart rate, APACHE 11 score, CVP, lactate, ScvO2 and CI had statistical1 significant difference between those before and after treatment in both groups （all P 〈0.05）. The CVP, ScvO2 and CI of low P（cv-a）CO2 group after treatment were higher than those of high P（cv-a）CO2 group, and the difference was statistically significant （P 〈0.05）. Conclusions P（cv-a）CO2 monitoring has important significance in the systemic tissue perfusion in patients with septic shock, which can effectively determine the patient＇s tissue perfusion and severity of disease, and is worthy of clinical promotion and application.