ScvO_(2)、Pcv-aCO_(2)双指标监测在感染性休克液体复苏治疗中的指导作用  

The guiding role of ScvO_(2),Pcv-aco_(2) monitoring in fluid resuscitation of septic shock

作　　者：赵文超 李燕 钟振强 ZHAO Wen-chao;LI Yan;ZHONG Zhen-qiang(Department of critical care medicine,Songgang people's Hospital of Bao'an District,Shenzhen City,Shenzhen 518105,China)

机构地区：[1]深圳市宝安区松岗人民医院重症医学科,广东深圳518105

出　　处：《吉林医学》2022年第3期594-596,共3页Jilin Medical Journal

基　　金：深圳市宝安区科技计划项目[项目编号:2020JD317]。

摘　　要：目的:探讨中心静脉饱和度(ScvO_(2))、中心静脉-动脉血二氧化碳分压差(Pcv-aCO_(2))双指标监测在感染性休克液体复苏治疗中的指导作用。方法:选取收治的64例感染性休克患者随机分为对照组和研究组,各32例,对照组通过监测ScvO_(2)指导液体复苏,研究组通过监测ScvO_(2)、Pcv-aCO_(2)双指标指导液体复苏,比较两组治疗效果。结果:研究组ICU入住时间、机械通气时间较对照组明显更短,差异有统计学意义(P<0.05);研究组去甲肾上腺素及多巴酚丁胺用量均较对照组明显减少,差异有统计学意义(P<0.05);两组液体复苏后的中心静脉压(CVP)、平均动脉压(MAP)、心脏指数(CI)、乳酸清除率、血肌酐(Scr)等指标均较治疗前明显改善,且研究组的改善效果优于对照组,差异有统计学意义(P<0.05)。结论:临床救治感染性休克患者的过程中,通过监测ScvO_(2)、Pcv-aCO_(2)双指标指导液体复苏治疗,可收获更理想的治疗效果。Objective To explore the guiding role of central venous saturation(ScvO_(2))and central venous arterial partial pressure of carbon dioxide(Pcv-aco_(2))in fluid resuscitation of septic shock.Method 64 patients with septic shock in our hospital were selected and randomly divided into control group(n=32)and study group(n=32).The control group guided fluid resuscitation by monitoring ScvO_(2),while the study group guided fluid resuscitation by monitoring ScvO_(2) and Pcv-aco_(2).The therapeutic effects of the two groups were compared.Results The ICU stay time and mechanical ventilation time of the study group were significantly shorter than those of the control group(P<0.05);the dosage of norepinephrine and dobutamine of the study group were significantly less than those of the control group(P<0.05);the central venous pressure(CVP),mean arterial pressure(MAP),cardiac index(CI),lactate clearance rate and serum creatinine(Scr)after fluid resuscitation in the two groups were significantly improved compared with those before treatment,and the improvement effect of the study group was better than that of the control group(P<0.05).Conclusion In the process of clinical treatment of patients with septic shock,monitoring ScvO_(2) and Pcv-aco_(2) to guide fluid resuscitation treatment can obtain more ideal therapeutic effect,which is worthy of clinical promotion.

关 键 词：ScvO_(2) Pcv-aCO_(2) 感染性休克 液体复苏 机械通气 

分 类 号：R459.7[医药卫生—急诊医学]