静动脉二氧化碳分压联合中心静脉血氧饱和度检测在脓毒性休克患者液体复苏中的指导作用

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摘要目的探讨静动脉二氧化碳分压（Pcv-aCO2）联合中心静脉血氧饱和度（ScvO2）检测在脓毒性休克患者液体复苏中的指导作用。方法选取2017年2月～2018年10月在我院就诊的40 例脓毒性休克患者作为研究对象，均给予液体复苏治疗，治疗过程中使用Pcv-aCO2 联合ScvO2 检测，比较复苏前后以及治疗后效果及监测指标。结果复苏6 h 后患者乳酸和Pcv-aCO2 含量低于液体复苏前，复苏6 h 后患者平均动脉压和ScvO2 指标高于液体复苏前，差异有统计学意义（P<0.05）。复苏前后患者的中心静脉压(CVP)含量和心率（HR）指标比较，差异无统计学意义（P＞0.05）。存活组的ScvO2 指标和乳酸清除率高于死亡组，而Pcv-aCO2 和APACHEⅡ评分低于死亡组，差异有统计学意义（P<0.05）。与高Pcv-aCO2 组比较，低Pcv-aCO2 组的乳酸清除率高且病死率低，差异有统计学意义（P<0.05）。结论 PV-aCO2 联合ScvO2 检测在脓毒性休克患者液体复苏中有较高的指导和应用价值，值得推广。

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	谭哲君
	莫文庆
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	陶剑锋

关键词 ：液体复苏, 脓毒性休克, 静动脉二氧化碳分压差, 中心静脉血样饱和度

Abstract：Objective To explore the guiding role of intravenous partial pressure of carbon dioxide (Pcv-aCO2) combined with central venous oxygen saturation (ScvO2) in fluid resuscitation in septic shock patients.Methods A total of 40 patients with septic shock who treated in our hospital from February 2017 to October 2018 were selected as the research objects.All patients were treated with liquid resuscitation.Pcv-aCO2 and ScvO2 were used to detect the effect and monitoring indicators before and after resuscitation.Results After 6 hours of resuscitation, the levels of lactic acid and Pcv-aCO2 were lower than those before fluid resuscitation, and the mean arterial pressure and ScvO2 were lower than those before fluid resuscitation (P<0.05）.There was no significant difference in central venous pressure (CVP) and heart rate (HR) before and after resuscitation (P＞0.05）.The ScvO2 index and lactate clearance rate of survival group were higher than those of death group, while the scores of Pcv-aCO2 and APACHEⅡwere lower than those of death group (P<0.05）.Compared with the high Pcv-aCO2 group, the low Pcv-aCO2 group had higher lactate clearance rate and lower mortality (P<0.05）.Conclusion Pcv-aCO2 combined with ScvO2 detection has high guidance and application value in fluid resuscitation of septic shock patients, and it is worth popularizing.

Key words： Fluid resuscitation Septic shock Static arterial partial pressure of carbon dioxide Central venous blood sample saturation

基金资助:广东省清远市社会发展领域自筹经费科技计划项目（2018B155）

作者简介: 谭哲君（1986-），女，广东连州人，本科，主治医师，研究方向：呼吸内科疾病

引用本文:

谭哲君；莫文庆；梁斐；梁慧娟；陶剑锋. 静动脉二氧化碳分压联合中心静脉血氧饱和度检测在脓毒性休克患者液体复苏中的指导作用[J]. 中国当代医药, 2019, 26(18): 48-50.
TAN Zhe-jun； MO Wen-qing； LIANG Fei； LIANG Hui-juan； TAO Jian-feng. Guiding role of intravenous carbon dioxide partial pressure combined with central venous oxygen saturation in fluid resuscitation in septic shock patients. 中国当代医药, 2019, 26(18): 48-50.

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