重症肺炎患者动脉血乳酸及中心静脉血氧饱和度监测的意义  

Significance of monitoring arterial blood lactic acid and central venous oxygen saturation in patients with severe pneumonia

作　　者：刘璇[1] 林凤[1] 管亚慧[1] Liu Xuan;Lin Feng;Guan Yahui(First People's Hospital of Guiyang,ICU,Guiyang,Guizhou,550001,China)

机构地区：[1]贵阳市第一人民医院重症医学科,贵州贵阳550001

出　　处：《当代医学》2019年第9期51-53,共3页Contemporary Medicine

基　　金：贵阳市卫生计生委科学技术计划项目[2015]筑卫科技合同字第025号

摘　　要：目的研究重症肺炎患者,监测动脉血乳酸(Lac)、中心静脉血氧饱和度(ScvO_2)的意义。方法本院47例重症肺炎患者(2015年1月至2018年3月),测定入院各时刻(0 h、6 h、24 h、72 h)动脉血Lac及ScvO_2,完成相关检验,进行入院前3 d急性生理与慢性健康(APACHE慢)评分,根据患者入院第28天预后,分为生存组及死亡组,记录两组各时段动脉血乳酸及ScvO_2,比较其差别及相关性。结果死亡组入院6 h、24 h、72 h动脉血Lac高于存活组,ScvO_2低于存活组,差异有统计学意义(P<0.05)。死亡组入院APACHE学评分更高,且6 h乳酸清除率较低。结论重症肺炎患者预后与动脉血Lac的6 h清除率及ScvO_2密切相关。Objective To investigate the significance of monitoring arterial blood lactic acid(Lac)and central venous oxygen saturation(ScvO2)in patients with severe pneumonia.Methods From January 2015 to March 2018,47 patients with severe pneumonia in our hospital were determined at times of admission hospital(0 h,6 h,24 h,72 h)of arterial blood Lac and ScvO2,and related tests were completed.Acute physiology and chronic health(APACHE II)scores were performed 3 days before admission.According to the prognosis of the 28th day of the patient's admission,it was divided into survival group and death group.The difference and correlation between the two groups of arterial blood lactic acid and ScvO2 were recorded.Results The death group was admitted to hospital with 6 h,24 h,and 72 h arterial blood Lac higher than the survival group,and Scv02 was lower than the survival group(P<0.05),and the difference was statistically significant.The death group was admitted to the APACHE II with a higher score and a lower removal rate of 6 h lactic acid.Conclusion The prognosis of patients with severe pneumonia is closely related to the rate of Lac 6 h clearance of arterial blood and ScvO2.

关 键 词：6h乳酸清除率 中心静脉血氧饱和度 APACHE-Ⅱ评分 

分 类 号：R563.1[医药卫生—呼吸系统]