Cv-aCO_2/Ca-vO_2、LCR、IVCrvi作为脓毒性休克患者早期复苏终点指标的可行性及价值研究

The effect of Cv-aCO_2/Ca-vO_2、LCR and IVCrvi as an early end point of resuscitation in patients with septic shock feasibility and value research

目的探讨静脉-动脉二氧化碳含量差/动脉-静脉氧含量差(Cv-a CO2/Ca-v O2)、乳酸清除率(LCR)与下腔静脉内径呼吸变异指数(IVCrvi)作为脓毒症休克患者早期复苏终点指标的可行性及价值。方法选取2016年6月至2018年2月该院收治的脓毒性休克患者60例,均进行早期液体复苏治疗,应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,以尿量大于0.5 m L/(kg·h)、平均动脉压大于65 mm Hg(1 mm Hg=0.133 k Pa)为达标,根据达标情况将患者分为达标组和未达标组。结果复苏治疗后所有患者Cv-a CO2/Ca-v O2、LCR及IVCrvi等指标均得到明显改善,达标组患者指标改善情况优于未达标组,差异均有统计学意义(P<0.05)。结论脓毒症休克患者早期复苏治疗可应用Cv-a CO2/Ca-v O2、LCR、IVCrvi进行评估,其对复苏治疗有重要指导价值。

Objective To explore the feasibility and value of Cv-aCO2/Ca-vO2,LCR and IVCrvi as the end point of early recovery in patients with septic shock.Methods Sixty patients with septic shock admitted to the hospital from June 2016 to February 2018 were enrolled.All patients underwent early fluid resuscitation and were evaluated with Cv-aCO2/Ca-vO2,LCR,IVCrvi.The urine volume was greater than 0.5 mL/(kg·h)and the mean arterial pressure was greater than 65 mm Hg(1 mm Hg=0.133 kPa).Patients were divided into the compliance group and the non-standard group according to the compli-ance criteria.Results After resuscitation treatment,Cv-aCO2/Ca-vO2,LCR and IVCrvi were significantly improved in all pa-tients.The improvement of index in patients in the standard group was better than that in the non-standard group,the differ-ence was statistically significant(P<0.05).Conclusion Early resuscitation in patients with septic shock can be assessed with Cv-aCO2/Ca-vO2,LCR,IVCrvi,which has important guiding value for resuscitation therapy.