摘要
目的:探讨中心静脉-动脉血二氧化碳分压差(Pcv-aCO_2)在评估急性心肌梗死后心源性休克严重程度及预后的价值。方法:回顾性分析2012-10-2014-12我院ICU收治的急性心肌梗死后心源性休克患者40例,根据入院时Pcv-aCO_2是否≥6mmHg(1mmHg=0.133kPa),将患者分为高Pcv-aCO_2组和低Pcv-aCO_2组。比较高Pcv-aCO_2组与低Pcv-aCO_2组之间相关数值的差异。结果:本研究显示2组患者入院时APACHEⅡ评分比较差异无统计学意义(P>0.05),具有可比性。在ScvO_2≥70%时,高Pcv-aCO_2组血乳酸(Lac)水平高于低PcvaCO2组。低Pcv-aCO_2组患者上呼吸机及主动脉内球囊反搏(IABP)时间、ICU住院时间均短于高Pcv-aCO_2组,且肾功能衰竭发生率低于高Pcv-aCO_2,差异有统计学意义(P<0.05)。2组患者炎性指标均有升高,差异无统计学意义(P>0.05)。结论:Pcv-aCO_2可用于早期评价急性心肌梗死后心源性休克严重程度及预后。
Objective：To assess the value of central venous-to-arterial carbon dioxide difference（Pcv-aCO_2）in evaluation of disease severity and prognosis in patients with acute myocardial infarction complicating cardiogenic shock.Method：There were 40 consecutive resuscitated acute myocardial infarction complicating cardiogenic shock patients from October 2012 to October 2014 included immediately after their admission into our ICU.The patients were divided into low Pcv-aCO_2 group and high Pcv-aCO_2 group according to a threshold of 6mmHg.Data were compared between the H-group and the L-group.Result：There were no significant differences between low PcvaCO_2 and high Pcv-aCO_2 patients in APACHEⅡscore（P〈0.05）.The cases whose ScvO_2 was higher than 70%,Lac and Pcv-aCO_2 values were significantly different（P〈0.05）.Compared with the high Pcv-aCO_2 group,the low Pcv-aCO_2 group had lower mechanical ventilation time,IABP ventilation time,ICU stay leneh and the renal failures incidence（P〈0.05）.Two groups of patients with inflammatory indexes have increased,there were no significant differences.Conclusion：The early level of Pcv-aCO_2 serves as a good index for predicting the prognosis of patients with Pcv-aCO_2.
出处
《临床急诊杂志》
CAS
2016年第2期143-146,共4页
Journal of Clinical Emergency
