摘要
目的研究中心静脉血氧饱和度（ScvO2）变化率与机械通气患者拔管成功率的相关性。方法采用前瞻性研究方法，选取ICU的机械通气患者63例次，按拔管结果分成两组，比较两组ScvO2、SaO2的差异。结果两组患者性别、年龄差异无统计学意义（P〉0．05）。两组ScvO2变化率、SaO2变化率差异有统计学意义（P〈0．05）。ScvO2变化率与拔管成功率呈负相关（r=-0．317，P=0．011），SaO2变化率与拔管成功率呈显著负相关（r=-0．390，P=0．002）。ScvO2变化率与SaO2变化率呈显著正相关（r=0．451，P=0．000）。ScvO2变化率和SaO2变化率ROC下面积分别为0．289、0．267。ScvO2变化率的截断点为0．05（敏感度97．4％，特异度95．3％）。结论ScvO2下降〈5％是拔管成功的可靠预测指标，ScvO2变化率对机械通气患者拔管成功率判断有一定的临床价值。
Objective To investigate the correlation of the change rate of entral venous blood ox- ygen saturation（ScvO2） and the success rate of extubation in patients with mechanical ventilation. Methods A perspective study was conducted. Sixty-three patients with mechanical ventilation in ICU were divided into two groups according with extubation result. The differences of ScvO2 and arterial oxygen saturation （SaO2） between the two groups were compared. Results No significant differences were found in the items such as age and sex among both groups （P 〉 0.05）. There were differences on the change rate of ScvO2 and the change rate of SaO2 between both groups （P 〈 0.05）. The change rate of ScvO2 correlated with the success rate of extubation negatively （r = -0.317, P = 0.011）. So was between the change rate of SaO2 and the success rate of extubation （r = - 0.390, P = 0.002）. There was significant correlation between the change rate of ScvO2 and the change rate of SaO2 （r = 0.451, P = 0.000）. To compare the area of the change rate of ScvO2 and the change rate of SaO2, their areas under the ROC curve were 0.289 and 0.267. Cut off value of the change rate of ScvO2 was 0.05 （sensitivity of 97.4%, specificity of 95.3%）. Conclusion We can use decrease of ScvO2 〈 5% as a predictor of the extubation success. It is of certain clinical value to determine the success rate of extubation in patients with mechanical ventilation by the change rate of ScvO2.
出处
《中国急救医学》
CAS
CSCD
北大核心
2016年第5期448-450,共3页
Chinese Journal of Critical Care Medicine
基金
北京协和医学基金会“睿E（睿意）急诊医学研究专项基金”（R2014014）
关键词
中心静脉血氧饱和度(ScvO2)
中心静脉血氧饱和度变化率
机械通气
拔管成功
Central venous blood oxygen saturation （ScvO2）
The change rate of entral venous blood oxygen saturation
Mechanical ventilation
Extubation success
