摘要
目的探讨静动脉二氧化碳分压差在脓毒症休克患者液体复苏中的作用。方法选取2017年1~12月在我院进行脓毒症休克治疗的78例患者作为研究对象。依据复苏达标测定时的Pcv-aCO2(6 mmHg)值作为临界值,将患者分为A组(低Pcv-aCO2组)与B组(高Pcv-aCO2组),各39例。分别对两组患者复苏前后的血流动力学指标、APACHEⅡ、SOFA评分及临床治疗效果进行评估并比较。结果两组患者复苏前的血流动力学各项指标无显著差异(P>0.05),B组复苏后的HR、Pcv-aCO2均高于A组(P<0.05),而两组复苏后的MAP、CVP及ScvO2水平无显著差异(P>0.05);B组复苏后的APACHEⅡ及SOFA评分均高于A组(P<0.05);B组的机械通气时间、ICU住院时间及病死率均高于A组(P<0.05)。结论对脓毒症休克患者进行治疗的过程中,可将静动脉二氧化碳分压差作为对其液体复苏效果进行有效评估的重要指标,对其治疗及预后评估具有至关重要的作用。
Objective To investigate the effect of carbon dioxide partial pressure difference between arteries and veins in fluid resuscitation in the patients with septic shock.Methods A total of 78 patients who were treated with septic shock in our hospital from January to December 2017 were selected as the subjects of this study.Patients were divided into group A(low Pcv-aCO2 group)and group B(high Pcv-aCO2 group)based on the Pcv-aCO2(6 mmHg)value at the time of resuscitation determination,with 39 cases in each group.Hemodynamic indices,APACHEⅡand SOFA scores,as well as clinical treatment effects before and after resuscitation were evaluated and compared between the two groups.Results There were no significant differences in hemodynamic parameters before shock between the two groups of patients(P>0.05).HR and Pcv-aCO2 in group B were higher than those in group A after shock(P<0.05),and there was no significant difference in MAP,CVP and ScvO2 levels between the two groups after shock(P>0.05);the APACHEⅡand SOFA scores in group B after resuscitation were higher than those in group A(P<0.05);the mechanical ventilation time,length of ICU stay and mortality were higher in group B than in group A(P<0.05).Conclusion In the course of treatment for the patients with septic shock,the partial pressure difference of carbon dioxide between the arteries and veins can be used as an important indicator to effectively evaluate the fluid resuscitation effect,which is of vital importance for its treatment and prognosis evaluation.
作者
徐芳芳
吴霞云
方红龙
XU Fangfang;WU Xiayun;FANG Honglong(Department of Critical Care Medicine,Quzhou People's Hospital in Zhejiang Province,Quzhou,324000,China)
出处
《中国现代医生》
2020年第24期24-27,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2017KY695)。
关键词
静动脉二氧化碳分压差
脓毒症休克
液体复苏
血流动力学指标
Static artery carbon dioxide partial pressure difference
Septic shock
Fluid resuscitation
Hemodynamic index
