中心静脉与混合静脉血氧饱和度监测术后血容量变化的比较

A Comparison Between Central Venous and Mixed Venous Oxygen Saturation During Changes of Blood Volume in Postoperative Period

目的比较中心静脉血氧饱和度（ｃｅｎｔｒａｌｖｅｎｏｕｓｏｘｙｇｅｎｓａｔｕｒａｔｉｏｎ，ＳｃｖＯ２，经右心房）与混合静脉血氧饱和度（ｍｉｘｅｄｖｅｎｏｕｓｏｘｙｇｅｎｓａｔｕｒａｔｉｏｎ，ＳｖＯ２，经肺动脉）在监测心脏术后血容量（ＢＶ）变化时的意义。方法２４例心脏手术后患者，分别于术后进入ＩＣＵ处于机械通气及睡眠状态（Ⅰ组）；术后６小时处于机械通气及清醒状态（Ⅱ组）；术后２０小时处于自主呼吸及清醒状态（Ⅲ组）；同时测定ＳｃｖＯ２，ＳｖＯ２，ＢＶ和其他血流动力学指标并进行相关分析。结果ＳｃｖＯ２与ＢＶ相关系数（ｒ）分别为Ⅰ组０．５８９１（Ｐ＜０．０１），Ⅱ组０．５５９０（Ｐ＜０．０１），Ⅲ组０．６９６２（Ｐ＜０．０１）；ＳｖＯ２与ＢＶｒ分别为Ⅰ组０．７８５６，Ⅱ组０．７７８１（Ｐ＜０．０１），Ⅲ组０．７２４３（Ｐ＜０．０１）；ＳｃｖＯ２与ＳｖＯ２ｒ分别为Ⅰ组０．８６８９，Ⅱ组０．８９７１，Ⅲ组０．９５１３（Ｐ＜０．０１）。表明ＳｃｖＯ２与ＢＶ，ＳｖＯ２在心脏术后不同状态下具有相关性。

Objective To compare central venous oxygen saturation (ScvO 2,superior vena cava)with the mixed venous oxygen saturation (SvO 2,pulmonary artery) during changes of blood volume (BV) in postoperative cardiac surgery. Methods Blood samples of 24 patients were taken:(Ⅰ) Immediately after entering to ICU(with mechanical ventilation);(Ⅱ) 6 hours after operations(with mechanical ventilation but consciousness) and (Ⅲ) 20 hours later (self breathing and consciousness). Results The correlation coefficient( r ) between ScvO 2 and BV were (Ⅰ) 0.5891( P <0.01),(Ⅱ) 0.5590( P <0.01),(Ⅲ) 0.6962( P <0.01) respectively; and the ones between SvO 2 and BV were (Ⅰ) 0.7856,(Ⅱ)0.7781,(Ⅲ)0.7243( P <0.01) respectively; and the ones between ScvO 2 and SvO 2 were (Ⅰ)0.8689,(Ⅱ)0.8971 and (Ⅲ) 0.9513( P <0.01) respectively. These results showed that there was a clear linear correlation between ScvO 2 and BV or SvO 2 postoperatively. Conclusion ScvO 2 can substitute for SvO 2 as a BV monitoring method for postoperative cardiac patients.