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目的观察中心静脉压动态变化(△CVP)与外周动脉压心排量监测(APCO)在感染性休克患者容量评估中的相关性。方法本研究采用前瞻性、观察性、队列研究的设计方法,选择2012年2月-2014年8月在医院重症医学科的感染性休克患者纳入研究。所有患者进行晶体液500ml 30min内静脉滴入,并用飞利浦监护仪进行补液前后中心静脉压测量,计算△CVP;用APCO持续监测扩容前后各项血流动力学指标变化,根据对扩容的反应(扩容后SV增加15%为有反应)将患者分为有反应组和无反应组,观察△CVP与APCO的相关性。评估△CVP在预测感染性休克患者容量反应中的临床价值。结果共有39例感染性休克患者纳入本研究,扩容后有反应者占58.9%(23/39),反应组△CVP为(1.6±0.9)mm Hg(P<0.05),无反应组△CVP为(4.2±1.6)mm Hg(P<0.05),△CVP与△SV呈显著负相关性(r=0.654 P=0.038)。结论中心静脉压的动态变化是容量评估中的较好指标,可用来指导临床液体治疗。
Objective To investigate the correlation between the dynamic change of central venous pressure (△ CVP) and peripheral arterial pressure monitoring (APCO) in evaluating the volume of patients with septic shock. METHODS: This prospective, observational, cohort study was conducted in a prospective, observational, and cohort study of selected patients in the hospital from January 2012 to August 2014 in a septic shock study. All patients underwent intravenous infusion of crystalloid solution 500ml within 30min, and measured the central venous pressure before and after rehydration with Philips monitor to calculate △ CVP. The changes of hemodynamic indexes before and after the expansion were monitored continuously by APCO. According to the response to expansion After 15% increase in SV for response) The patients were divided into response and non-response groups observed △ CVP and APCO correlation. Evaluate the clinical value of △ CVP in predicting volume response in patients with septic shock. Results A total of 39 patients with septic shock were included in this study. Responders accounted for 58.9% (23/39) after dilatation and response. The CVP was (1.6 ± 0.9) mm Hg in response group (P <0.05), and △ CVP was (4.2 ± 1.6) mm Hg (P <0.05). There was a significant negative correlation between △ CVP and △ SV (r = 0.654 P = 0.038). Conclusion The dynamic change of central venous pressure is a good indicator of capacity assessment, which can be used to guide clinical fluid therapy.