脓毒性休克患儿血液氧代谢指标变化及其临床意义

Changes in blood oxygen metabolism indices and their clinical signifcance in children with septic shock

摘要:

脓毒性休克治疗的关键是提供充足的氧供和改善组织灌注，目前常用的反映氧代谢的指标是乳酸 （Lac）和中心静脉血氧饱和度 （ScvO₂），但是当乳酸和ScvO₂处于正常范围时，组织仍然可能存在缺氧。静动脉二氧化碳分压差 （CO₂ gap）在ScvO₂正常时可以准确反映机体氧供情况。本文就乳酸和乳酸清除率、ScvO₂和CO₂ gap在判断组织缺氧时的优点和不足进行综述，以期为脓毒性休克的治疗和病情判断提供依据。

Abstract:

The key to the treatment of septic shock is to provide adequate oxygen supply and improve tissue perfusion. Lactate and central venous oxygen saturation (ScvO₂) are commonly used as the indices of oxygen metabolism, but tissue hypoxia may still exist even when lactate and ScvO₂ are within the normal range. Arteriovenous difference in carbon dioxide partial pressure (CO₂ gap) can accurately reflect oxygen delivery when ScvO₂ is in the normal range. This article reviews the advantages and shortages of lactate, lactate clearance rate, ScvO₂, and CO₂ gap in evaluating tissue hypoxia, in order to provide a reference for treatment and severity evaluation of septic shock.