监测ScvO_2在COPD并发呼吸衰竭患者中的临床应用

Clinical application of ScvO_2 monitoring in COPD complicating respiratory failure patients

目的研究ScvO2在COPD并发呼吸衰竭患者中的临床应用价值。方法收集COPD并发呼吸衰竭患者共54名,根据预后分为死亡组及临床好转组两组,监测患者在不同病程阶段的ScvO2及血乳酸变化情况,并对两者进行相关性分析。结果两组患者ScvO2的比较:死亡组患者在病程早、中、晚期的ScvO2分别为(71.22±10.83)%、(64.75±13.64)%、(58.65±15.87)%,对照组则为(72.55±10.32)%、(73.03±9.81)%、(74.53±7.25)%,死亡组患者在病程中、晚期的值与对照组比较,差异均有统计学意义(t分别=2.60、4.97,P均<0.05)。两组患者血乳酸值的比较:死亡组患者在病程早、中、晚期的血乳酸值分别为(0.88±0.16)mmol/L、(1.01±0.42)mmol/L、(5.82±2.62)mmol/L,对照组则为(0.86±0.17)mmol/L,(0.89±0.30)mmol/L、(0.86±0.15)mmol/L,死亡组患者在病程晚期的血乳酸值与对照组比较,差异有统计学意义(t=10.73,P<0.05)。ScvO2与血乳酸值具有直线负相关关系(r=-0.69,P<0.05)。结论在COPD并发呼吸衰竭患者中,ScvO2能反映病情变化,且能比血乳酸更早出现异常。

Objective To study the clinical value of ScvO 2 in COPD patients complicating respiratory failure. Methods Fifty four COPD patients complicating respiratory failure from ICU were involved and divided into two groups ： the dead group and the living group. ScvO2 and blood lactic acid in different periods of disease were compared, and the correlation analysis between the two indexes were undertaken. Results The ScvO2 from patients of dead group were respectively （ 71.22 ± 10.83 ） % （ earlier stage ）, （ 64.75 ± 13.64 ） % （intermediate stage ）, （ 58.65 ± 15.87） % （ advanced stage ）, and that of control group were （72.55 ± 10.32） %, （73.03 ± 9.81 ） %, （ 74.53 ± 7.25） %. Significant differences were found in intermediate stage and advanced stage （ t = 2.60, 4.97, beth P 〈 0.05） ; The blood lactic acid were respectively （ 0.88 ± 0.16） mmol/L, （ 1.01 ± 0.42） mmol/L, （5.82 ± 2.62）mmol/L,and the control group were （0.86 ± 0.17） retool/L, （0.89 ± 0.30） mmol/L, （ 0.86 ± 0. 15）mmol/L. A significant difference was found in the advanced stage（t = 10.73, P 〈 0.05） ; There was linear correlation between ScvO2 and blood lactic acid （ v = - 0.69, P 〈 0.05） . Conclusions ScvO2 can reflect patient＇ s condition, and its abnormality appears more early than blood lactic acid.