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目的:探讨脓毒症早期液体复苏中连续动态监测血乳酸并联合中心动-静脉二氧化碳分压差在脓毒症早期液体复苏中的意义。方法:收集2012-2014年于我科救治的46例脓毒症患者,根据静-动脉血二氧化碳分压差(Pcv-aCO2)进行分组,同时监测2组患者心排量(CO)、血乳酸(Lac)及乳酸清除率、平均动脉压(MAP)变化情况。结果:比较治疗后12,24h两组研究对象的质量效果。结论:脓毒症患者积极早期液体复苏治疗后Pcv-aCO2≥6mmHg时仍提示全身组织灌注不足,Pcv-aCO2可以作为经过早期液体复苏治疗后ScvO2>70%的脓毒症患者进一步液体治疗的复苏的指标。
OBJECTIVE: To investigate the significance of continuous dynamic monitoring of blood lactic acid in the early stage of resuscitation of sepsis combined with arterial-venous carbon dioxide partial pressure difference in the early resuscitation of sepsis. Methods: Forty-six patients with sepsis who were treated in our department from 2012 to 2014 were enrolled in this study. The patients were divided into groups according to the difference of the partial pressure of arterial-arterial carbon dioxide (Pcv-aCO2), and the levels of cardiac output (CO), blood lactate (Lac) and lactic acid clearance, mean arterial pressure (MAP) changes. Results: The quality of the two groups were compared at 12 and 24 hours after treatment. Conclusion: Pcv-aCO2≥6mmHg after active early liquid resuscitation in patients with sepsis still suggests systemic tissue insufficiency. Pcv-aCO2 can be used as a further liquid therapy for sepsis patients with ScvO2> 70% after early liquid resuscitation index of.