摘要
目的探讨动静脉二氧化碳分压差[P(cv-a)CO2]监测在感染性休克中的临床意义。方法选取2016年1月-2018年1月在郑州大学附属洛阳市中心医院治疗的感染性休克患者60例,给予液体复苏治疗达标后,根据P(cv-a)CO2水平分为A组[P(cv-a)CO2≥6 mmHg]和B组[P(cv-a)CO2<6 mmHg],比较两组平均动脉压(mean arterial pressure,MAP)、中心静脉压(central venous pressure,CVP)、中心静脉血氧饱和度(central venous oxygen saturation,ScvO2)等水平。结果 A组患者25例,B组患者35例,两组患者性别、年龄、感染部位比较差异无统计学意义;B组复苏6 h CVP、ScvO2以及乳酸清除率分别为(12.01±1.40)mmHg、(80.41±3.50)%和(31.10±5.33)%,均高于A组(10.12±1.33)%、(71.14±2.33)%和(22.45±4.33)%(P<0.05);B组28 d病死率为20.00%,低于A组52.00%(P<0.05)。结论感染性休克患者液体复苏达标后,P(cv-a)CO2可作为进一步组织灌注评估指标,且有助于患者预后判断。
OBJECTIVE To investigate the clinical significance of arteriovenous carbon dioxide partial pressure difference[P(cv-a) CO2] in the treatment of infective shock. METHODS Totally 60 patients with infective shock treated in our hospital from Jan. 2016 to Jan. 2018 were selected. They were divided into A group monitoring of arteriovenous carbon dioxide partial pressure difference≥6 mmHg) and B group(P(cv-a)CO2<6 mmHg) after according to the P(cv-a) CO2 level when they met the standard after treated with fluid resuscitation. The mean arterial pressure(MAP), central venous pressure(CVP) and central venous oxygen saturation(ScvO2) were compared between the two groups. RESULTS There were 25 patients in group A and 35 patients in group B. There was no significant difference in gender, age and infection site between the two groups. The CVP, ScvO2 and lactate clearance after 6 h of resuscitation in group B were(12.01±1.40) mmHg,(80.41±3.50)% and(31.10±5.33)%, which were significantly higher than those in group A 10.12±1.33)%,(71.14±2.33)% and(22.45±4.33)%(P<0.05). The mortality rate of 28 d in group B was 20%, which was significantly lower than that in group A(52.00%)(P<0.05). CONCLUSION After reaching the standard by fluid resuscitation in patients with infective shock, P(cv-a) CO2 can be used as an indicator of further tissue perfusion and is helpful for the prognosis of patients.
作者
乔国华
朱平
岳磊
岳胜
李燕平
QIAO Guo-hua;ZHU Ping;YUE Lei;YUE Sheng;LI Yan-ping(Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第16期2410-2413,共4页
Chinese Journal of Nosocomiology
关键词
动静脉二氧化碳分压差
感染性休克
液体复苏
预后
Arteriovenous carbon dioxide partial pressure difference
Infective shock
Fluid resuscitation
Prognosis
