中心静脉血氧饱和度及乳酸在感染性休克中的意义

目的探讨中心静脉血氧饱和度及动脉血乳酸在感染性休克患者液体复苏中的指导作用。方法将入选的感染性休克患者56例分为两组,对照组28例和实验组28例,对照组采用感染性休克常规治疗及中心静脉压力监测指导补液;实验组采用感染性休克常规治疗,中心静脉压力监测和中心静脉血氧饱和度、动脉血乳酸测定指导补液治疗。于6 h内评价其中心静脉压(CVP)、平均动脉压(MAP)、心率、每小时尿量、中心静脉血氧饱和度和乳酸达标情况,对是否发生MODS进行判断。结果入选的56例患者中有26例发生MODS(46.43%),死亡23例(41.07%)。实验组MODS发生比例和死亡率分别为39.29%和32.14%,低于对照组的53.57%和50.00%,两组比较差异具有统计学意义(P<0.05)。结论中心静脉血氧饱和度(ScVO2)及乳酸测定指导感染性休克患者的液体复苏可以降低MODS发病率及死亡率。

Significance of Testing Central Venous Oxygen Saturation and Lactic Acid in Patients with Septic Shock

Objective To evaluate the clinical utility of central venous oxygen saturation and lactic acid tests in fluid resuscitation of patients with septic shock.Methods A total of 52 cases with septic shock were divided into control group(n=28) and experimental group(n=28).Both groups received the septic shock treatment.The fluid resuscitation was carried out by monitoring the central venous pressure(CVP) in the control group and by monitoring the CVP,central venous blood oxygen saturation(SCVO2) and arterial blood lactic acid in the experimental group.The levels of CVP,mean arterial pressure(MAP),heart rate(HR),Urine 1-hour volume,SCVO2 and blood lactic acid were tested to judge the risk of multiple organ dysfunction syndrome(MODS).Results There were 26 in 56 cases with MODS with a rate of 46.43%,and 23 cases died(41.07%).The rate of MODS and mortality in the experimental group was 39.29% and 32.14%,respectively;and in the control group was 53.57% and 50.00%,respectively,the difference between the two groups was significance(P<0.05).Conclusion The fluid resuscitation guided by testing the levels of SCVO2 and arterial blood lactic acid can decrease the rate of MODS and mortality in patients with septic shock.