休克患者微循环状态监测研究进展

Progress of Monitoring on Microcirculation in Patients with Shock

微循环障碍是休克的本质,临床发现大循环与微循环有脱节的情况,而微循环能否有效改善与预后相关,因此早期发现微循环障碍并迅速逆转是治疗休克的关键。目前临床上微循环状态的监测方法有很多,包括肉眼观察、动脉血乳酸和混合静脉血氧饱和度监测、胃黏膜酸碱度(pHi)测定、旁流暗视野(SDF)成像技术、经皮氧分压(TcPO2)监测、激光散斑血流成像(LSFG)技术等,从直接到间接,从整体到局部,从物理学方法到化学方法,每个方法各有优缺点,本文主要对临床中常用的各种微循环监测方法作一综述,为临床工作中的选择提供一定的参考依据。

Microcirculation disorder is the essence of shock.which is found disjointed with great circulation in clinic.Whether microcirculation can be effectively improved is positively related to prognosis.Therefore,early detection and rapid reversal of microcirculation disorder is the key to the treatment of shock.At present,there are many methods to monitor microcirculation.It includes naked eye observation,arterial blood lactate and mixed venous oxygen saturation monitoring,pondus hydrogenii(pHi)measurement,destream darkfield imaging(SDF)technology,transcutaneous oxygen partial pressure(TcPO2)monitoring,laser speckle flow graphy(LSFG)technology,from direct to indirect,from whole to local,from physical method to chemical method.Each method has its own advantages and disadvantages.This paper reviews the monitoring methods of microcirculation state in patients with shock,and provide some reference basis for the selection of clinical work.