感染性休克患者不同部位毛细血管充盈时间与乳酸清除率的相关性研究  

Correlation between capillary filling time and lactate clearance rate in patients with septic shock

作　　者：崔文博 李尊柱 李奇 孙建华 罗红波 赵明曦 邓海波 Cui Wenbo;Li Zunzhu;Li Qi;Sun Jianhua;Luo Hongbo;Zhao Mingxi;Deng Haibo(Department of Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Cardiac Surgery Department,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院重症医学科,100730 [2]中国医学科学院北京协和医院心外科病房,100730

出　　处：《中国实用护理杂志》2021年第19期1458-1461,共4页Chinese Journal of Practical Nursing

基　　金：北京市科技计划项目课题(Z201100005520007)。

摘　　要：目的分析感染性休克患者不同部位毛细血管充盈时间(CRT)与乳酸清除率的相关性,为CRT在感染性休克患者的临床应用提供参考。方法选择2019年1—12月北京协和医院重症医学科收治的70例感染性休克患者作为研究对象。在患者入ICU和入ICU 6 h后2个时间段分别采集3个部位(前额、膝盖、甲床)的CRT、平均动脉压、序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分、机械通气情况、乳酸清除率等指标,分别比较不同部位CRT变化与乳酸清除率的相关性。结果当6 h内乳酸清除率>10%时,3个部位中只有甲床部位CRT与患者乳酸清除率有相关性,3个部位的Pearson系数分别为甲床0.823(P<0.05),额头0.232(P>0.05),膝盖0.254(P>0.05)。当患者6 h内乳酸清除率<10%时,3个部位与患者乳酸清除率均无相关性,3个部位的Pearson系数分别为甲床0.299(P>0.05),额头0.247(P>0.05),膝盖0.258(P>0.05)。结论当6 h内乳酸清除率>10%时,甲床部位的CRT与患者的乳酸清除率有良好的相关性,甲床部位的CRT变化可成为临床评估微循环的实用工具。Objective To analyze the correlation between capillary filling time(CRT)and lactate clearance rate in patients with septic shock,so as to provide reference for the clinical application of CRT in patients with septic shock.Methods A prospective study was conducted on 70 patients with septic shock.CRT,mean arterial pressure(map)and sequential organ failure(SOFA)score,Acute Physiology and Chronic Health Evaluation Scoring System(APACHEⅡ)score,mechanical ventilation and lactate clearance rate were collected at 3 sites(forehead,knee and nail bed)respectively at 2 time points after admission and 6 hours after admission.The correlation between CRT changes and lactate clearance rate was compared.Results When lactate clearance rate of more than 10% in 6 hours,the Pearson coefficients of the three sites were 0.823 for nail bed(P<0.05),0.232 for forehead and 0.254 for knee(P>0.05).When lactate clearance rate of less than 10% in 6 hours,the Pearson coefficients of the three sites were 0.299 for nail bed,0.247 for forehead and 0.254 for knee(P>0.05).Conclusion When lactate clearance rate of more than 10% in 6 hours,there is a good correlation between the CRT of nail bed and the lactate clearance rate of patients.The CRT of nail bed can be a practical tool for clinical evaluation of microcirculation.

关 键 词：感染性休克 毛细血管充盈时间 乳酸清除率 

分 类 号：R459.7[医药卫生—急诊医学]