论文部分内容阅读
目的探讨危重症新生儿血液二氧化碳分压[pa(CO2)]及胃肠道二氧化碳分压[pi(CO2)]的变化及其临床意义。方法危重症组和普遍疾病组患儿分别于入院第1、3、7天、健康对照组于入院第1天经股动脉采血,应用血气分析的方法测定pa(CO2),采用胃张力测定管Tonometry Catheter导管测定pi(CO2),计算出胃肠道与血液二氧化碳分压比值[pi(CO2)/pa(CO2)]、胃肠道与血液二氧化碳分压差值[pi(CO2)-pa(CO2)]。选取患儿病情危重及死亡时以上指标作为病情危重的预警值,并计算其敏感性及特异性。结果1.与健康对照组比较,危重症组儿童各时相pi(CO2)值均增高,第1、3天随病情变化渐升高(Pa<0.01),之后有降低趋势,第7天时仍高于健康对照组(P<0.05)。2.危重症组与健康对照组pi(CO2)/pa(CO2)、pi(CO2)-pa(CO2)在第1、3天均有显著差异(Pa<0.05)。3.pi(CO2)在危重症组中变化早于pa(CO2),恢复晚于pa(CO2)。4.pi(CO2)/pa(CO2)、pi(CO2)-pa(CO2)变化趋势与pi(CO2)相同。5.在作为预警的指标中,pi(CO2)的敏感性及特异性均较高,联合应用pi(CO2)和pi(CO2)/pa(CO2),pi(CO2)和pi(CO2)-pa(CO2)更好。结论监测p(CO)和p(CO)水平可早期发现胃肠功能障碍,指导治疗,在危重症预警方面有重要价值。
Objective To investigate the changes of blood partial pressure of carbon dioxide (pa) and partial pressure of carbon dioxide in the gastrointestinal tract (pi (CO2)) in critically ill neonates and their clinical significance. Methods Children in critical illness group and common disease group were collected on the 1st, 3rd and 7th day of admission respectively. The healthy control group on the first day of admission were collected blood via the femoral artery, blood gas analysis was used to determine pa (CO2) Pi (CO 2) / pa (CO 2)], the difference between the partial pressure of carbon dioxide in the gastrointestinal tract and the blood [pi (CO 2) -pa CO2)]. Select the children with critical illness and death above indicators as critical illness warning value, and calculate the sensitivity and specificity. Compared with the healthy control group, the levels of pi (CO2) increased significantly in all critically ill children at each time point, and gradually increased with the change of the disease on the first and third days (Pa <0.01), then decreased, and on the seventh day Higher than the healthy control group (P <0.05). The levels of pi (CO2) / pa (CO2), pi (CO2) -pa (CO2) in critically ill patients and healthy volunteers were significantly different at the first and third days (Pa0.05). 3.pi (CO2) changes in critical illness group earlier than pa (CO2), recovery later than pa (CO2). 4.pi (CO2) / pa (CO2), pi (CO2) -pa (CO2) The trend of change is the same as pi (CO2). 5. As an indicator of early warning, the sensitivity and specificity of pi (CO2) are high, and the combination of pi (CO2) and pi (CO2) / pa (CO2), pi pa (CO2) is better. Conclusions Monitoring of p (CO) and p (CO) levels can detect gastrointestinal dysfunction early and guide treatment. It is of great value in early warning of critical illness.