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影响.docVIP

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影响 　　[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0 h、6 h、12 h、24 h、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6 h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。 　　[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 　　[中图分类号] R459.7[文献标识码] B[文章编号] 1673-9701（2014）15-0024-03 　　 　　Early dynamic monitoring of blood lactate and central venous oxygen saturation and intervention measures affecting the prognosis for septic shock patients 　　YAN Ling CAI Guolong 　　Zhejiang Hospital in Zhejiang Province，Hangzhou 310013， China 　　[Abstract] 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 Choose48 cases patients with septic shock treated as the observed object from January 2010 to January 2013 in our hospital ICU， 48 casespatients condition weredivided 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 comparedby dynamic monitoring 0 h，6 h，12 h， 24 h，48 h，72 h. Results LAC level of observation group weremonitoring 0~12 h showed no change，and the differences werenot significantbetween the two groups（P0.05）； 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（P0.05). ScvO2 levels of observation group gradually in