早期血乳酸与中心静脉血氧饱和度对脓毒症休克患者预后的影响

Study on early blood lactate and central venous oxygen saturation in septic shock patients

目的研究早期血乳酸(LAC)及中心静脉氧饱和度(ScvO2)对脓毒症休克患者预后及疗效评估。方法患者均按EGDT(Early Goal-Directed Therapy)及脓毒症集束化治疗,保证充分氧供,通过对病情变化及预后分析将患者分为72 h病情好转组及72 h病情加重组,对2组患者动态监测患者0、6、12、24、72 h LAC及ScvO2,对比2组LAC及ScvO2变化情况。结果好转组及恶化组患者24 h内LAC下降幅度不明显,而24 h后LAC明显变化。对于ScvO2,好转组治疗早期即有显著动态变化,72 h内逐渐上升;恶化组早期变化不明显,72 h内无变化或持续恶化。结论早期监测ScvO2对脓毒症休克患者预后判断较LAC更为敏感。

Objective To study the early blood lactate and central venous oxygen saturation in patients with septic shock prog- nosis and efficacy evaluation. Methods According to EGDT （Early Goal - Directed Therapy） in patients and sepsis cluster treatment, to ensure sufficient oxygen supply, through the analysis of changes in condition and prognosis of the patients were divided into condition improved within 72h group （group A） and condition deteriorated within 72h group （group B）. The patients with dynamic monitoring of blood lactate and central venous oxygen saturation were performed in patients at 0 hour, 6 hours, 12 hours, 24 hours and 72 hours and blood lactate and central venous oxygen saturation were compared in two groups. Results The improved group and the deterioration group of the patients within 24 hours of blood lactate decline was not obvious, but significant changes in lactic acid after 24 hours. The central venous oxygen saturation was significantly increased within 72 hours in improved group; but it was not significantly increased within 72 hours in group B. Conclusion The early detection of central venous oxygen saturation in patients with septic shock as progno- sis judgment is more sensitive than the blood lactate.