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目的探讨血氧灌注指数(PI)值在足月儿休克中的临床应用价值。方法选取2013年7月至2014年12月本院新生儿科收治的足月休克新生儿为观察对象,按新生儿休克评分分为轻度、中度、重度休克组,选取同期收治的足月高危新生儿为对照组。休克组在诊断休克时以及治疗后24、48 h分别测定PI值,对照组在出生后2、24、48h分别测定PI值,比较各组PI值的变化。结果休克组48例,其中轻、中、重度休克分别为15、26、7例;对照组43例。轻、中、重度休克组和对照组新生儿在性别、胎龄、出生体重、分娩方式等方面差异均无统计学意义(P>0.05)。轻、中、重度休克组诊断休克时PI值[(1.06±0.12)、(0.69±0.17)、(0.15±0.06)]均低于对照组生后2 h PI值(3.82±0.75),差异有统计学意义(P<0.01)。轻、中、重度3组之间休克严重程度越重,P1值越低,差异有统计学意义(P<0.01)。治疗后24 h轻、中、重度休克组PI值[(1.89±0.49)、(1.48±0.47)、(0.98±0.29)]均较治疗前升高,差异有统计学意义(P<0.01),但仍低于对照组生后24 h PI值(3.85±1.01)差异有统计学意义(P<0.05)。治疗后48 h随休克的纠正,轻、中、重度休克组PI值明显升高[(3.02±0.93)、(3.05±0.85)、(3.02±0.72)]并逐渐趋于稳定,与对照组生后48 h PI值(3.88±0.80)比较差异无统计学意义(P>0.05)。结论足月儿休克时PI值明显下降,且休克程度越重PI值越低,治疗后PI值逐渐升高并趋于稳定。动态监测新生儿PI值有助于临床足月新生儿休克的诊断和治疗。
Objective To investigate the clinical value of blood oxygen perfusion index (PI) in term infants. Methods From July 2013 to December 2014, newborn infants in full-term neonates admitted to neonatal department of our hospital were selected as observation objects. According to the neonatal shock score, patients were divided into mild, moderate and severe shock groups. Neonates for the control group. In shock group, the PI value was measured at 24 h and 48 h after the diagnosis of shock, and the PI value was measured at 2, 24 and 48 h after birth in the control group, and the changes of PI value in each group were compared. Results Forty-eight cases were treated with shock, including 15, 26, and 7 cases of mild, moderate and severe shock respectively and 43 cases of control group. There was no significant difference in sex, gestational age, birth weight, mode of delivery among mild, moderate and severe shock group and control group (P> 0.05). PI value in the mild, moderate and severe shock group was significantly lower than that of the control group (3.82 ± 0.75) at 2 h after shock ([1.06 ± 0.12], (0.69 ± 0.17), (0.15 ± 0.06)], respectively Statistical significance (P <0.01). The severity of shock in the mild, moderate and severe groups was more severe. The lower the P1 value, the difference was statistically significant (P <0.01). The PI values in mild, moderate and severe shock group at 24 h after treatment were significantly higher than those before treatment (P <0.01), and were significantly higher than those before treatment (1.89 ± 0.49, 1.48 ± 0.47, 0.98 ± 0.29, But still lower than the control group 24 h PI (3.85 ± 1.01) difference was statistically significant (P <0.05). At 48 h after treatment, with the correction of shock, the PI values in mild, moderate and severe shock group were significantly higher than those in control group [(3.02 ± 0.93), (3.05 ± 0.85), (3.02 ± 0.72)], After 48 h PI value (3.88 ± 0.80) no significant difference (P> 0.05). Conclusion The PI value of full-term infantile shock decreased significantly, and the PI value of the shock was lower than that of the shock. The PI value gradually increased and stabilized after the treatment. Dynamically monitoring neonatal PI values contributes to the diagnosis and treatment of clinical full-term neonatal shock.