摘要
目的 探讨早期动态监测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,从而为实施有效的干预对策提供指导依据.方法 选择2010年1月～2013年1月我院ICU收治的脓毒症休克患者48例作为观察对象,分为观察组30例,72 h内存活并重要脏器功能稳定;对照组8例,72 h内病情持续恶化或死亡,比较两组患者动态监测0h、6h、12h、24h、48 h、72 h血LAC、ScvO2的变化情况.结果 观察组患者的LAC水平0～12 h监测均未见明显变化（P＞0.05）;观察组24～72 h监测LAC水平明显降低,且观察组患者的LAC水平分别明显低于对照组,组间比较,差异有统计学意义（P＜0.05）.对照组患者LAC水平动态监测0～72 h未见明显差异（P＞0.05）.观察组患者ScvO2含量监测至6h后逐渐升高,且6～72 h监测ScvO2含量分别明显高于对照组,组间比较,差异有统计学意义（P＜0.05）,但对照组患者ScvO2含量从6～72 h监测呈逐渐降低的趋势.结论 早期动态监测血乳酸与中心静脉血氧饱和度可以判断脓毒症休克患者的预后,有利于发现脓毒症休克病情变化并采取积极的干预措施.
Objective To investigate the effect of early dynamic monitoring of blood lactate and central venous oxygen saturation of patients with septic shock prognosis ,to provide guidance for the implementation of effective interventions based countermeasures. Methods Choose 48 cases patients with septic shock treated as the observed object from Jan- uary 2010 to January 2013 in our hospital ICU, 48 cases patient＇s condition were divided into observation group 30 cases,72 h memory alive and vital organ function and stability;The control group 18 patients within 72 h continuous disease progression or death,the blood LAC,ScvO2 changes were compared by dynamic monitoring 0 h,6 h, 12 h, 24 h, 48 h,72 h. Results LAC level of observation group were monitoring 0-12 h showed no change,and the differences were not significant between the two groups （P〉O.05） ; LAC of monitoring 24-72 h levels were significantly lower, LAC level of observation group were significantly lower than control group,the differences was significant between the two groups （P〈0.05）.The LAC level dynamic monitoring 0-72 h of the control group patients had no significant differ- enee（P〉0.05）. ScvO2 levels of observation group gradually increased after 6 h,and the 6~72 h monitoring SevO2 con- tents were significantly higher, the difference was significant between two groups （P〈O.05）. But ScvO2 content of control group patients gradually decreased from 6-72 h was monitored. Conclusion Early dynamic monitoring of blood lactate and central venous oxygen saturation can determine the prognosis of patients with septic shock,which provide guidance for the implementation of effective intervention based on countermeasures, in favor of founding septic shock condition changes and take proactive interventions.
出处
《中国现代医生》
2014年第15期24-26,30,共4页
China Modern Doctor
基金
浙江省医药卫生重大科技计划(WKJ2012-2-020)
关键词
脓毒症休克
血乳酸
中心静脉血氧饱和度
动态监测
预后
Septic shock
Blood lactate
Central venous oxygen saturation
Dynamic monitoring
Prognosis
