动脉血二氧化碳分压监测联合被动抬腿试验评估循环衰竭患者的容量反应性

Combination of arterial carbon dioxide partial pressure monitoring and passive leg raising test in evaluating capacity reactivity of patients with circulation failure

目的探究动脉血二氧化碳分压监测联合被动抬腿试验评估循环衰竭患者容量反应性的应用价值。方法选取梅州市人民医院2015年1月至2016年1月收治的80例循环衰竭患者作为研究对象,将容量负荷试验后心脏指数(cardiac index,CI)≥15%基础值[3.0~3.5 L/(min·m^2)]作为容量负荷试验阳性"金标准"分为对照组(容量负荷试验阴性组)和研究组(容量负荷试验阳性组)各40例,均进行被动抬腿试验联合动脉血二氧化碳分压监测,评估两组患者容量反应性。结果研究组心率、平均动脉压、每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)、动脉血二氧化碳分压、氧合指数与对照组相比较,差异具有统计学意义(P<0.05)。结论动脉血二氧化碳分压监测联合被动抬腿试验可作为评估循环衰竭患者的容量反应性参照指标,值得在临床推广使用。

Objectives To study the clinical value of the combination of arterial carbon dioxide partial pressure（PaCO2）monitoring and passive leg raising（PLR）test in evaluating capacity reactivity of patients with circulation failure.Methods Totally 80 patients with circulation failure treated in Meizhou People′s Hospital during January 2015 to January 2016 were selected and divided into control group（load capacity test negative group）and research group（load capacity test positive group）according to the basic value[3.0-3.5 L/（min·m2）]of cardiac index（CI）≥15%,which was adopted as the golden standard.Each group had 40 cases and all the subjects received PLR test along with PaCO2 monitoring to evaluate their capacity reactivity.Results There were significant differences in heart rate（HR）,mean artery pressure（MAP）,cardiac output（CO）,stroke volume（SV）,PaCO2 and oxygenation index between research group and control group（P〈0.05）.Conclusions Combination of PaCO2 monitoring and PLR test can be used for evaluating capacity reactivity of patients with circulation failure and this method is worthy of clinical use in a wide range.