Pcv-aCO2/Ca-cvO2对腹部肿瘤脓毒症手术预后的预测

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Therapeutics and Clinical Risk Management Pub Date : 2022-10-07 eCollection Date: 2022-01-01 DOI:10.2147/TCRM.S374414
Yang Lyu, Tao Han, Meirong Liu, Keliang Cui, Donghao Wang
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引用次数: 1

摘要

背景:探讨Pcv-aCO2/Ca-cvO2联合Pcv-aCO2对腹部肿瘤术后并发腹腔感染脓毒症患者预后的预测作用。方法:选取2017年1月至2020年12月我院收治的92例腹部肿瘤手术患者。记录不同时间点动脉、中心静脉血气分析、各项实验室指标、SOFA评分、血流动力学参数及治疗效果。结果:ROC曲线分析显示,单纯的血流动力学参数不能预测ICU患者的治疗结局和死亡率,但72小时SOFA评分可以预测患者的治疗结局(AUC = 0.930, 95% CI: 0.803 ~ 1.000, p = 0.019)。Pcv-aCO2 + T3比值是评价患者治疗效果和预后的重要血流动力学参数。Kaplan-Meier单因素生存曲线和Log-rank提示T3 Ratio + T3 Pcv-aCO2联合预测参数较高的患者在标准液体复苏后仍存在组织器官缺血缺氧,治疗效果不佳。在亚组分析中,比值越高的患者乳酸水平越高,T72 SOFA评分越高,治疗效果越差。结论:比值联合Pcv-aCO2可评价腹部肿瘤术后并发腹腔感染脓毒症患者的临床治疗效果。
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The Prediction of Surgery Outcomes in Abdominal Tumor Patients with Sepsis by Pcv-aCO2/Ca-cvO2.

Background: To determine whether Pcv-aCO2/Ca-cvO2 combined with Pcv-aCO2 could predict the outcomes in patients complicated with abdominal infection and sepsis after abdominal tumor operation.

Methods: Total 92 patients admitted to our hospital from January 2017 to December 2020 who underwent abdominal tumor operation were enrolled. Blood gas analysis of artery and central vein, various laboratory indexes, SOFA score, hemodynamic parameters at different time points and treatment outcome were recorded.

Results: ROC curve analysis showed that hemodynamic parameter alone could not predict ICU treatment outcome and mortality of patients, but 72-hour SOFA score could predict treatment outcome of patients (AUC = 0.930, 95% CI: 0.803-1.000, p = 0.019). The significant hemodynamic parameter for evaluating treatment outcome and prognosis of patients was Pcv-aCO2 + Ratio of T3. Kaplan-Meier univariate survival curve and Log-rank suggested that patients who had higher combined predictive parameter of T3 Ratio + T3 Pcv-aCO2 still had ischemia and hypoxia of tissues and organs after standard fluid resuscitation, and treatment outcome was not good. In subgroup analysis, patients with higher Ratio had higher lactate, higher T72 SOFA score, and poor treatment outcome.

Conclusion: The combination of Ratio and Pcv-aCO2 could evaluate clinical treatment outcome of patients complicated with abdominal infection and sepsis after abdominal tumor operation.

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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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