摘要
目的分析感染性休克患者复苏前后经皮氧分压(P_(tc)O_(2))相关指标与常用氧代谢指标的相关性。方法选取2015年7月—2017年7月浙江医院感染性休克患者40例为研究对象,6 h持续监测P_(tc)O_(2),并于0 h、6 h行氧负荷试验(OCT)、动脉血气分析及中心静脉血气分析。分析P_(tc)O_(2)值、OCT值(吸入纯氧10 min后P_(tc)O_(2)值-基础P_(tc)O_(2)值)与乳酸清除率、中心静脉血氧饱和度(S_(cv)O_(2))之间的相关性。结果6 h后P_(tc)O_(2)及ΔP_(tc)O_(2)(6 h P_(tc) O_(2)~0 h P_(tc)O_(2))均与乳酸清除率呈正相关(r=0.386和0.555,P<0.05),ΔP_(tc)O_(2)与ΔS_(cv)O_(2)(6 h S_(cv)O_(2)~0 h S_(cv)O_(2))呈正相关(r=0.377,P<0.05),ΔOCT(6 h OCT~0 h OCT)与ΔS_(cv)O_(2)呈正相关(r=0.372,P<0.05)。复苏6 h后,P_(tc)O_(2)改善程度不同的两组患者,在乳酸清除率、6 h S_(cv)O_(2)、去甲肾上腺素需求量上差异有统计学意义(P<0.05),OCT改善程度不同的两组患者,乳酸清除率差异有统计学意义(P<0.05)。结论复苏前后P_(tc)O_(2)、OCT的变化与乳酸清除率、S_(cv)O_(2)变化值相关,有可能用于评估复苏的有效性。
Objective To analyze the correlation between transcutaneous oxygen pressure(P_(tc)O_(2))related variables and the classical oxygen metabolism variables before and after resuscitation in patients with septic shock.Methods Forty patients with septic shock were prospectively investigated.P_(tc)O_(2) was continuously monitored for 6 hours,and oxygen challenge test(OCT),arterial blood gas analysis,and central venous blood gas analysis were performed at 0h and 6h.The correlation between P_(tc)O_(2) related variables(P_(tc)O_(2) value and OCT value)and lactate clearance rate and central venous oxygen saturation(S_(cv)O_(2))were analyzed respectively.Results After 6 h,P_(tc)O_(2) value andΔP_(tc)O_(2)(6 h P_(tc)O_(2) value to 0 h P_(tc)O_(2) value)were positively correlated with lactate clearance rate(r=0.386 and 0.555,P<0.05).The positive correlation was also proved betweenΔP_(tc)O_(2) andΔS_(cv)O_(2)(6 h S_(cv)O_(2) to 0 h S_(cv)O_(2))(r=0.377,P<0.05),ΔOCT(6 h OCT value to 0 h OCT value)andΔS_(cv)O_(2)(r=0.372,P<0.05),respectively.There were significant differences in lactate clearance,6 h S_(cv)O_(2),and norepinephrine requirement between the two groups with different changes of P_(tc)O_(2) after 6 hours of resuscitation(P<0.05).There was also a significant difference in lactate clearance between the two groups with different OCT improvements(P<0.05).Conclusion Changes in P_(tc)O_(2) and OCT before and after resuscitation were related to lactate clearance and changes in S_(cv)O_(2),which may be used to assess the effectiveness of resuscitation.
作者
徐靓
龚仕金
王敏佳
叶聪
Liang Xu;Shi-jin Gong;Min-jia Wang;Cong Ye(Department of Critical Care Medicine,Zhejiang Hospital,Hangzhou,Zhejiang 310013,China)
出处
《中国现代医学杂志》
CAS
北大核心
2022年第3期60-64,共5页
China Journal of Modern Medicine
基金
浙江省医药卫生科技计划项目(No:2015KYB002)。
关键词
感染性休克
经皮氧分压
氧负荷试验
血乳酸
中心静脉血氧饱和度
septic shock
transcutaneous oxygen pressure
oxygen challenge test
blood lactate
central venous oxygen saturation
