脑氧饱和度监测指导脑灌注对感染性休克患者血流动力学及脑钠肽的影响  

Effect of Cerebral Oxygen Saturation Monitoring to Guide Cerebral Perfusion on Hemodynamics and Brain Natriuretic Peptide in Patients with Septic Shock

作　　者：袁博[1] YUAN Bo(ICU of Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院ICU,黑龙江佳木斯154002

出　　处：《医学信息》2021年第15期112-114,118,共4页Journal of Medical Information

摘　　要：目的探讨感染性休克患者应用脑氧饱和度监测指导下脑灌注效果及患者脑钠肽和血流动力学指标变化分析。方法选取我院2017年8月~2020年8月收治的78例感染性休克患者作为研究对象,采用随机数字分组法分为观察组与对照组,每组39例。对照组给予常规脑灌注治疗,观察组给予脑氧饱和度监测指导下脑灌注治疗,比较两组复苏前后的血流动力学指标、脑钠肽、乳酸水平、组织灌注及氧代谢情况、28天病死率、ICU入住时间及APACHEⅡ评分。结果两组复苏前CVP、PaO_(2)/FiO_(2)、HR、MAP、脑钠肽、乳酸水平比较,差异无统计学意义(P>0.05);观察组复苏48 h后CVP、MAP、脑钠肽、乳酸水平低于对照组,差异有统计学意义(P<0.05);两组患者复苏前尿量、PaO_(2)、VO_(2)、DO_(2)、ScvO_(2)、Hb比较,差异无统计学意义(P>0.05);复苏后观察组尿量、PaO_(2)、ScvO_(2)高于对照组,PaO_(2)低于对照组,差异有统计学意义(P<0.05);两组28天病死率比较,差异无统计学意义(P>0.05);观察组ICU入住时间低于对照组、APACHEⅡ评分高于对照组,差异有统计学意义(P<0.05)。结论脑氧饱和度监测指导脑灌注治疗感染性休克效果确切,能够促进患者血流动力学指标恢复,降低脑钠肽与乳酸水平,提升患者组织灌注及氧代谢情况,且安全性好,值得临床应用。Objective To explore the effect of cerebral perfusion under the guidance of cerebral oxygen saturation monitoring in patients with septic shock and analysis of changes in brain natriuretic peptide and hemodynamic indexes in patients.Methods A total of 78 patients with septic shock admitted to our hospital from August 2017 to August 2020 were selected as the research objects.They were divided into observation group and control group by random number grouping method,with 39 cases in each group.The control group was given conventional cerebral perfusion therapy,and the observation group was given cerebral perfusion therapy under the guidance of cerebral oxygen saturation monitoring.The hemodynamic indexes,brain natriuretic peptide,lactic acid level,tissue perfusion and oxygen metabolism,28-day mortality,ICU stay time and APACHEⅡscore before and after resuscitation were compared between the two groups.Results There was no significant difference in the levels of CVP,PaO_(2)/FiO_(2),HR,MAP,brain natriuretic peptide,and lactic acid between the two groups before resuscitation(P>0.05);The levels of CVP,MAP,brain natriuretic peptide,and lactic acid in the observation group were lower than those in the control group after 48 hours of resuscitation,the difference was statistically significant(P<0.05);There was no significant difference in urine output,PaO_(2),VO_(2),DO_(2),ScvO_(2),and Hb between the two groups of patients before resuscitation(P>0.05);After resuscitation,the urine volume,PaO_(2) and ScvO_(2) of the observation group were higher than those of the control group,and PaO_(2) was lower than the control group,the difference was statistically significant(P<0.05);There was no significant difference in the 28-day mortality rate between the two groups(P>0.05);The ICU stay time of the observation group was lower than that of the control group,and the APACHEⅡscore was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Cerebral oxygen saturation monitoring is effecti

关 键 词：脑氧饱和度监测指导 脑灌注 感染性休克 脑钠肽 血流动力学 

分 类 号：R631.4[医药卫生—外科学]