中心静脉血氧饱合度联合乳酸清除率监测指导在脓毒性休克液体复苏的效果分析  

Effect of central venous oxygen saturation combined with lactate clearance monitoring on liquid resuscitation in septic shock

作　　者：辛恺[1] 王海波 薛倩茹 何松彬[1] 龙艳红 XIN Kai;WANG Haibo;XUE Qianru;HE Songbin;LONG Yanhong(ICU,The First People’s Hospital of Huizhou City,Huizhou 516001,China)

机构地区：[1]广东省惠州市第一人民医院危重医学科

出　　处：《包头医学院学报》2019年第10期12-13,16,共3页Journal of Baotou Medical College

基　　金：惠州市科技计划项目(180614111740394)

摘　　要：目的:探讨分析中心静脉血氧饱度联合乳酸清除率监测指导脓毒性休克液体复苏的效果;方法:选取2018年1月~2018年12月本院重症医学科收治的60例脓毒性休克患者随机分为研究组和对照组,对照组在中心静脉压(CVP)≥8 mmHg、平均动脉压(MAP)≥65 mmHg、尿量≥0.5 mL/kg/h、Scv O2≥70%完成液体复苏,研究组在对照组基础上+血乳酸清除率≥10%完成液体复苏,比较治疗后3、6、24 h中心静脉血氧饱和度、乳酸清除率,两组机械通气时间、ICU住院时间及28 d死亡率;结果:两组患者治疗后3、6、24 h中心静脉血氧饱和度、乳酸清除率均显著上升(P<0.05),但组间比较两组患者治疗后3、6、24 h中心静脉血氧饱和度、乳酸清除率无统计学差异(P>0.05),研究组患者通气时间、ICU住院时间显著缩短,28d死亡率仅为6.67%,显著降低(P<0.05);结论:中心静脉血氧饱合度联合乳酸清除率监测指导在脓毒性休克液体复苏效果更好,显著缩短通气时间和ICU住院时间,降低28 d死亡率,值得应用。Objective:To investigate the effect of central venous oxygen saturation combined with lactate clearance monitoring on fluid resuscitation in septic shock.Methods:60 patients with septic shock admitted to the Department of Critical Care Medicine from January 2018 to December 2018 were selected and divided into study group and control group randomly.The control group completed fluid resuscitation at central venous pressure(CVP)≥8 mmHg,mean arterial pressure(MAP)≥65 mmHg,urine volume≥0.5 m1/kg/h and Scv O 2≥70%,and the study group was added with blood lactate clearance rate≥10%on the basis of the control group.The central venous oxygen saturation and lactate clearance at 3,6,and 24 h after treatment,mechanical ventilation time,ICU stay,and 28-day mortality were compared in the two groups.Results:Central venous oxygen saturation and lactate clearance were significantly increased at 3,6,and 24 h after treatment(P<0.05),but there was no significant difference in oxygen saturation and lactate clearance rate between the two groups(P>0.05).The ventilation time and ICU hospitalization time were significantly shortened in the study group,and the mortality was only 6.67%at 28 days,which was significantly lower(P<0.05).Conclusion:Central venous blood oxygen saturation combined with lactate clearance monitoring in the guidance of fluid resuscitation in septic shock is better,which shortens ventilation time and ICU hospitalization time,and reduces 28d mortality.It should be recommended to be clinically popularized.

关 键 词：中心静脉血氧饱度 乳酸清除率 脓毒性休克 液体复苏 

分 类 号：R47[医药卫生—护理学]