中心静脉血氧饱和度对老年脓毒性休克患者容量反应性的预测价值

发布时间：2018-04-29 01:28

本文选题：中心静脉血氧饱和度 + 容量反应性　；参考：《重庆医学》2017年06期

【摘要】：目的通过比较容量负荷试验前后中心静脉血氧饱和度(ScvO_2)变异度和心输出量(CO)变异度的关系,来判断老年脓毒性休克患者ScvO_2对容量反应性预测价值。方法对符合脓毒性休克诊断标准的45例老年脓毒性休克患者,建立中心静脉导管(CVC)及连续心排血量监测(PICCO);进行容量负荷试验,用250mL 0.9%盐水快速静脉输注,试验前后分别抽取中心静脉导管血做血气分析,记录ScvO_2数值,并记录CO数值;对二者变异度进行t检验,Pearson相关性分析、ROC曲线用来测试指标的反应能力。结果 45例老年脓毒性休克患者容量负荷试验前后平均动脉压(MAP)、心率(HR)、CO、ScvO_2指标比较差异有统计学意义(P0.05),45例老年脓毒性休克患者容量负荷试验前后CO与ScvO_2呈线性相关(P0.01)。容量负荷试验前后ScvO_2的变化同CO的变化是密切相关的(r=0.781,P0.01)。结论 ScVO_2动态变化可以作为判定老年脓毒性休克患者对容量反应性的指标。
[Abstract]:Objective to evaluate the value of ScvO_2 in predicting volume reactivity in elderly patients with septic shock by comparing the relationship between the variability of central venous oxygen saturation (scvO _ 2) and cardiac output (CO) before and after volumetric load test. Methods 45 elderly patients with septic shock who met the diagnostic criteria of septic shock were treated with central venous catheterization (CVC) and continuous cardiac output monitoring (PICCOC), volume load test, and rapid intravenous infusion of 250mL 0.9% saline. Before and after the experiment, the central venous catheter blood was collected for blood gas analysis, ScvO_2 value and CO value were recorded, and the correlation analysis between them was performed by t test and Pearson correlation analysis. Results there was a significant difference in the mean arterial pressure (MAPP) and heart rate (HR) in 45 elderly patients with septic shock before and after volume load test (P 0.05). There was a linear correlation between CO and ScvO_2 before and after volume load test (P 0.01) in 45 elderly patients with septic shock. The change of ScvO_2 is closely related to the change of CO before and after volumetric load test. Conclusion the dynamic changes of ScVO_2 may be used as an index to judge the volume reactivity of elderly patients with septic shock.
【作者单位】：锦州医科大学航天中心医院研究生培养基地;
【分类号】：R459.7

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