乳酸清除率、SVRI水平及心排量监测与感染性休克患者治疗效果及预后的关系
Relationship between lactic acid clearance,SVRI and cardiac displacement monitoring and the therapeutic effect and prognosis of patients with septic shock
黄新蕾 1许伟恒 1刘冬辉 1张雪萌1
作者信息
- 1. 保定市第二中心医院重症医学科,河北,保定 072750
- 折叠
摘要
目的 研究感染性休克患者乳酸清除率、体循环阻力指数(SVRI)水平及心排量监测与其治疗及预后的关系.方法 选取2020年6月至至2022年5月保定市第二中心医院收治的感染性休克患者161例,统计患者临床治疗效果及预后情况,分析影响感染性休克患者治疗疗效、预后的相关因素;采用Pearson相关性分析乳酸清除率、心排血量(CO)、每搏输出量(SV)、SVRI与APACHEⅡ评分的关系.结果 161例患者中,有效组90例、无效组71例,两组乳酸、乳酸清除率、CO、SV、体循环阻力指数(SVRI)及APACHEⅡ评分比较,差异均有统计学意义(P<0.05);经Logistic回归分析显示:乳酸(<198 mmol/L,>245 mmol/L)、乳酸清除率<10%、CO(<3 L/minm,>6 L/minm)、SV(<60 mL,>120 mL)、SVRI(<1 500 dyn/s/m-2/cm-5,>2 000 dyn/s/m-2/cm-5)及APACHEⅡ评分>24分是影响感染性休克患者治疗效果的危险因素(P<0.05).统计28d预后情况可知:预后不良者95例,预后良好者66例,两组乳酸、乳酸清除率、CO、SV、SVRI及APACHEⅡ评分比较,差异均有统计学意义(P<0.05).经Logistic回归分析显示:乳酸(<198 mmol/L,>245 mmol/L)、乳酸清除率<10%、CO(<3 L/minm,>6 L/minm)、SV(<60 mL,>120 mL)、SVRI(<1 500 dyn/s/m-2/cm-5,>2 000 dyn/s/m-2/cm-5)及APACHEⅡ评分>24分是影响感染性休克患者预后的危险因素(P<0.05).经Pearson相关性分析结果显示:APACHEⅡ评分与乳酸清除率、CO、SV均呈负相关,与乳酸、SVRI均呈正相关(P<0.05).结论 监测感染性休克患者乳酸清除率、SVRI水平及心排量指标均可为临床评估治疗效果、预后提供有效参考价值.
Abstract
Objective To study the relationship of lactic acid clearance,systemic resistance index(SVRI)and cardiac displacement monitoring with treatment and prognosis of patients with septic shock.Meth-ods 161 patients with septic shock admitted to the Second Central Hospital of Baoding City from June 2020 to May 2022 were selected.The clinical therapeutic effect and prognosis of patients were counted.The related factors affecting the therapeutic effect and prognosis of patients with septic shock were analyzed.The relation-ship between lactic acid clearance,cardiac output(CO),stroke output(SV),SVRI and APACHEⅡ score was analyzed by Pearson correlation.Results Among 161 patients,90 cases were in the effective group and 71 cases were in the ineffective group,there were statistically significant in lactic acid,lactic acid clearance,CO,SV,systemic vascular resistance index(SVRI),and APACHEⅡ scores(P<0.05).Logistic regression analysis showed that lactic acid<198 mmol/L and lactic acid>245 mmol/L,lactic acid clearance<10%,CO<3 L/minm and CO>6 L/minm,SV<60 mL and SV>120 mL,SVRI<1 500 dyn/s/m-2/CM-5 and SVRI>2 000 dyn/s/m-2/cm-5 and APACHEⅡscores>24 were risk factors affecting the therapeutic effect of septic shock pa-tients(P<0.05).According to the statistics of the 28 d prognosis,95 cases had poor prognosis and 66 cases had good prognosis.There were significant differences in lactic acid,lactic acid clearance,CO,SV,SVRI and APACHEⅡ scores between the two groups(P<0.05).Logistic regression analysis showed that lactic ac-id<198 mmol/L and lactic acid>245 mmol/L,lactic acid clearance<10%,CO<3 L/minm and CO>6 L/minm,SV<60 mL and SV>120 mL,SVRI<1 500 dyn/s/m-2/cm-5 and SVRI>2 000 dyn/s/m-2/cm-5 and APACHEⅡ scores>24 were risk factors affecting the therapeutic effect of septic shock patients(P<0.05).Pearson correlation analysis showed that APACHEⅡ score was negatively correlated with lactic acid clear-ance,CO and SV,and positively correlated with lactic acid and SVRI(P<0.05).Conclusion Monitoring lactate clearance,SVRI level and cardiac displacement in patients with septic shock can provide effective refer-ence value for clinical evaluation of treatment effects and prognosis.
关键词
乳酸清除率/心排量监测/体循环阻力指数/感染性休克Key words
Lactate clearance rate/Cardiac displacement monitoring/Systemic Vascular Resis-tance/Septic shock引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据