毛细血管充盈时间预测脓毒性休克病人预后的价值  

Significance of capillary refill time in predicting prognosis of septic shock

作　　者：笪伟[1] 张泓[1] DA Wei;ZHANG Hong(Department of Emergency Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院急诊科,安徽合肥230022

出　　处：《安徽医药》2020年第6期1171-1173,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评估皮肤毛细血管充盈时间(CRT)在脓毒性休克病人中的应用价值。方法2016年5月至2019年5月安徽医科大学第一附属医院收治的脓毒性休克73例,根据脓毒性休克病人28 d转归分为存活组(35例)与死亡组(38例),采用非参数检验比较两组病人CRT,通过受试者工作特征曲线(ROC)分析CRT预测脓毒性休克病人预后的阈值及其灵敏度与特异度等诊断试验评价指标。结果死亡组CRT明显高于存活组[5.50(4.40,5.90)s比2.20(1.90,2.80)s,P<0.05]。ROC曲线下面积(AUC)显示:AUC=0.83,最佳截断值为2.4 s时预测脓毒性休克病人死亡,灵敏度高达94%,特异度为84%。结论脓毒性休克6 h液体复苏后CRT可以预测脓毒性休克病人的预后。Objective To evaluate the application value of skin capillary filling time(CRT)in patients with septic shock.Methods Seventy-three cases of patients with septic shock in Departments of Emergency,The First Affiliated Hospital of Anhui Medical University from May 2016 to May 2019 were selected and assigned into survival group(35 cases)and death group(38 cases)according to 28 days outcome in patients with septic shock.Nonparametric test was used to compare two groups of patients with capillary refill time(CRT),the ROC curve analysis of the CRT was used to predict the prognosis of patients with septic shock threshold and its degree of sensitivity and specific diagnostic test evaluation index.Results The CRT of death group was obviously higher than that of survival group,and the difference was statistically significant[5.50(4.40,5.90)s vs.2.20(1.90,2.80)s,P<0.05].The area under curve(AUC)of ROC showed that AUC was 0.83,and the best cut-off value was 2.4 s to predict the death of patients with septic shock,with a sensitivity of 94% and a specificity of 84%.Conclusion After 6 hours of fluid resuscitation,CRT can predict the prognosis of the patients with septic shock.

关 键 词：休克 脓毒性 毛细血管充盈时间 乳酸 血压 微循环 预后 

分 类 号：R459.7[医药卫生—急诊医学]