早期中心静脉血氧饱和度监测在急性左心衰中的意义

Significance of early central venous blood oxygen saturation in patients with acute left ventricular failure

目的探讨早期中心静脉血氧饱和度(ScvO2)监测在急性左心衰中的意义。方法将43例急性左心衰竭患者分为两组,生存组28例和死亡组15例,监测治疗前及治疗后1h、2h、4h的ScvO2、血氧饱和度(SaO2)、心率(HR)、呼吸频率(RR)的变化情况。结果生存组治疗后ScvO2呈进行性上升,死亡组ScvO2呈进行性下降,1h、2h、4hScvO2均高于死亡组,差异均有统计学意义(t分别=2.81、6.44、9.49,P均<0.05);生存组治疗后1hSaO2、RR、HR与死亡组比较,差异均无统计学意义(t分别=0.60、0.65、-0.59,P均>0.05);治疗后2h、4hRR、HR生存组低于死亡组,SaO2生存组高于死亡组,差异均有统计学意义(t分别=-2.95、-4.95、-3.76、-3.88、2.88、4.27,P均<0.05)。结论ScvO2能反映急性左心衰竭患者病情变化,早期监测对判断其预后有重要意义。

Objective To study the significance of early central venous blood oxygen saturation detection in patients with acute left ventricular failure.Methods A total of 43 cases with acute left ventricular failure were divided into survival group（n=28）and death group（n=15）,the heart rate（HR）,respiratory rate（RR）,blood oxygen saturation（SaO2） and central venous blood oxygen saturation（ScvO2）were observed before and 1 hour,2 hours,4 hours after treatment.Results Compared with the death group,ScvO2 in the survival group increased significantly 1 hour,2 hours,4 hours after treatment（t=2.81,6.44,9.49,P0.05）;significant differences were found in HR,RR,SaO2 2 and 4 hours after treatment between the two groups（t=-2.95,-4.95,-3.76,-3.88,2.88,4.27,P0.05）,but not for 1 hour（t=0.60,0.65,-0.59,P0.05）.Conclusions The early levels of ScvO2 in patients with acute left ventricular failure can reflect patient＇s condition and play important role in estimation of prognosis of illness.