【作者】 明自强； 俞林明；

【Author】 MING Ziqiang;YU Lingming;Department of Emergency and Critical Care Medicine,Xinchang People Hospital;

【机构】 浙江省新昌县人民医院ICU；

【摘要】 目的:探讨重症急性胰腺炎患者监测动静脉血二氧化碳分压差[P(cv-a)CO2]的临床意义。方法:2010年1月-2015年2月我院符合重症急性胰腺炎诊断的患者随机选取40例,根据患者基线时[P(cv-a)CO2]水平分为高P(cv-a)CO2组[P(cv-a)CO2≥6 mm Hg]与低P(cv-a)CO2组[P(cv-a)CO2<6mm Hg],所有患者均给予早期目标指导性治疗(EGDT),观察2组患者6 h EGDT达标率、ICU病死率及28 d病死率等。结果:与高P(cv-a)CO2组比较,低P(cv-a)CO2组患者基线时中心静脉血氧饱和度较高,乳酸水平较低(P<0.05),6h EGDT达标率高(P<0.05),两组患者ICU死率及28 d病死率差异无计学意义(P>0.05)。结论:P(cv-a)C02可作为评估重症急性胰腺炎患者组织灌注与疾病严重程度的临床指标。更多还原

【Abstract】 Objective:To assess the value of central venous-to-arterial carbon dioxide difference[P(cv-a)C02]in evMuation of disease severity and prognosis in patients with severe acute pancreatitis. Methods:There were 40 consecutive resuscitated severe acute pancreatitis patients from.January 2010 to March 2013 included immediately after their admission into our ICU。 The patients were divided into low P(cv-a) C02 group and high P(cv-a)C02 group according to a threshold of 6mm Hg(1mmHg=0.1 33 kPa)。 All patients were treated by early goal directed therapy(EGDT)。 The parameters of hemodynamics,lactate clearance rate the Acute Physiology and 6 h rate of EGDT achievement,the ICU mortality and 28 days in-hospital mortality were recorded for all patients。 Results:Compared with the high P(cv-a) CO2 group,the low P(cv-a) CO2 group higher central venous oxygen saturation(ScvO2),lower laerate and higher 6 h rate of EGDT achievement(P<0.05),however,there were no differences in 28 days mortality and ICU mortsdity between the two groups(P>0.05).Conclusion:P(cv-a) CO2 might be an indicator for predicting the severity of patients with severe acute pancreatitis and evaluating tissue perlusion。更多还原