脓毒症休克患儿ITBVI与中心静脉压关系及治疗分析  

Relationship between ITBVI and Central Venous Pressure in Children with Septic Shock and its Treatment

作　　者：李正然[1] 付四毛[1] 梁展图[1] 马力忠[1] 莫庆仪[1] Li Zhengran et al(Pediatrics Dept, Zhongshan universal love hospital（Zhongshan Guangdong, 528400)

机构地区：[1]广东中山市博爱医院儿科,广东中山528400

出　　处：《黑龙江医药》2017年第3期487-490,共4页Heilongjiang Medicine journal

基　　金：中山市医学科研基金项目(编号:2013A020093)

摘　　要：目的:探讨脓毒症休克患儿胸腔内血容量指数(ITBVI)和中心静脉压(CVP)相关性及其治疗方法。方法:抽取我院儿科重症监护室接诊的脓毒症休克患儿50例进行研究,回顾性分析他们的临床资料,根据2008年脓毒症救治指南实施液体复苏,检测ITBVI与CVP水平,总结不同水平CVP上的ITBVI值,分析二者之间的相关性,采取注射用头孢哌酮钠舒巴坦钠、注射用美罗培南及注射用盐酸万古霉素等治疗。结果:50例患儿复苏后有创平均动脉压(MAP)、心率(HR)、心脏指数(CI)、ITBVI、每搏输出量指数(SI)与复苏前相较均有显著性差异(P<0.05);CVP在0-8mm Hg与>12mm Hg时,与ITBVI间无相关性(P>0.05),但CVP为8-12mm Hg时,则与ITBVI间有明显正相关(P<0.05);50例患儿治疗后半年生存率为96.00%,仅有2例患儿因病情较重而死亡。结论:脓毒症休克患儿复苏后MAP、HR、CI等均有明显改善,但CVP与ITBVI间并无明显相关性,仅仅CVP处于复苏目标时有正相关,为此不适合作为单独参考指标。Objective： To study the sepsis shock with intrathoracic blood volume index （ITBVI） and central venous pressure （CVP） correlation and its treatment. Method： To extract the hospital pediatric intensive care unit accepts sepsis shock with 50 cases were studied, and their clinical data were retrospectively analyzed, according to a 2008 sepsis treatment guide implementation of fluid resus- citation, detect ITBVI and CVP level, summarizes the different levels of CVP ITBVI value, analyzed the correlation between them, take the shope depth, beauty and steady reliable treatment. Result： 50 cases recovery after a mean arterial pressure （MAP）, heart rate （HR）, cardiac index （CI）, ITBVI, stroke volume index （SI） compared with before the recovery had significant difference （P〈0.05）; CVP during 0 to 8 MMHG and 〉 12 MMHG, and there is no correlation between ITBVI （P〉0.05）, but the CVP for 8 to 12 MMHG, and have obvi- ous positive correlation between ITBVI （P〈O.05）; 50 cases underwent treatment late survival rate was 96.00%, only 2 cases died of ill- ness heavier. Conclusion： children with sepsis shock recovery after MAP, HR, CI, ete all have markedly improved, hut there is no ob- vious correlation between CVP and ITBVI, CVP only in recovery have a positive correlation, therefore not suitable for as a separate ref- erence index.

关 键 词：脓毒症休克 患儿 胸腔内血容量指数 中心静脉压 相关 

分 类 号：R631[医药卫生—外科学] R72[医药卫生—临床医学]