摘要
目的系统评价静动脉二氧化碳分压差(Venous arterial carbon dioxide pressure difference,V-ApCO2)联合中心静脉血氧饱和度(central venous oxygen saturation,ScvO2)在感染性休克液体复苏治疗中的指导作用。方法依据Cochrane协作网文献检索方法,联合检索中国生物医学文献数据库(CBMdisc)、中国知识资源总库(CNKI)、万方数据知识服务平台等,获得有关V-ApCO2联合ScvO2在感染性休克液体复苏治疗过程中指导作用的研究报道,时间截止2018年10月31日。以标准化均数差(SMD)或相对危险度(RR)评价V-ApCO2联合ScvO2在研究组和对照组感染性休克患者液体复苏治疗和预后相关指标。结果共纳入12篇文献,包含感染性休克患者818例,其中研究组450例,对照组368例。Meta分析结果显示,复苏6 h研究组患者急性生理与慢性健康(APACHEⅡ)评分、机械通气时间、ICU住院时间及28天病死率均低于对照组,而乳酸清除率高于对照组,差异均有统计学意义(P<0.05)。结论V-ApCO2和ScvO2联合作为液体复苏指标,有助于改善患者预后,减少机械通气时间、ICU住院时间以及减少病死率。
OBJECTIVE Systematic evaluation was conducted for the effect of carbon dioxide partial pressure difference of the static artery(V-ApCO2)combined with central venous oxygen saturation(ScvO2)on guided fluid resuscitation for septic shock.METHODS According to Cochrane collaborative network literature retrieval methods and combined retrieval of Chinese biomedical literature database(CBMdisc),Chinese knowledge resources database(CNKI)and the Wan Fang data knowledge service platform,papers published before Oct.31,2018 on V-ApCO2 combined with ScvO2 guidance in septic shock fluid resuscitation during treatment were obtained.The standardized mean difference(SMD)or relative risk(RR)was used to evaluate the effects of V-ApCO2 and ScvO2 on fluid resuscitation and prognosis in patients with septic shock in the observation group and the control group.RESULTS A total of 12 eligible articles were included,including 818 patients with septic shock cases,among which 450 were in the observation group and 368 were in the control group.Meta analysis showed that the Acute Physiology and Chronic Health Evaluation(APACHE II)score,mechanical ventilation time,ICU hospitalization time and the 28 day mortality rate of the patients in the observation group after 6 h resuscitation were significantly lower than those in the control group,while the lactic acid clearance rate was significantly higher than that of the control groupf(P<0.05).CONCLUSION Combination of V-ApCO2 and ScvO2 as indicators of fluid resuscitation can help improve the prognosis of patients,reduce the time of mechanical ventilation and the length of stay in ICU,and decrease the fatality rate.
作者
李丽
李正艳
秦玲
林宇斌
温建立
LI Li;LI Zheng-yan;QIN Ling;LIN Yu-bin;WEN Jian-li(Third Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第19期2899-2904,共6页
Chinese Journal of Nosocomiology
基金
合肥市科学技术局基金资助项目{遵市科合社字[2013]01号}
