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目的：改进动脉血气图，使之能适应不同吸氧浓度的血气标本，并研究急性呼吸窘迫综合征（ＡＲＤＳ）患者动脉血气指标在动脉血气图上的表现及其临床意义。方法：在吸氧条件下，动脉血气图作如下变动：①将吸入氧分压代入肺泡气公式，从而确定在该吸氧浓度下，对应于肺泡二氧化碳分压的肺泡氧分压；②根据不同吸氧浓度下肺泡动脉血氧分压差，确定该吸氧浓度下，对应于肺泡二氧化碳分压的理想动脉血氧分压。观察ＡＲＤＳ患者确诊时和出院前血气分析的变化。结果：①确诊ＡＲＤＳ时，患者的动脉血气指标在血气图上分布为通气过度合并换气损害区（６区）８例和通气代偿换气损害区（４区）３例均存活；通气不足合并换气损害区（５区）４例、６区５例和４区１例患者死亡前血气指标均处于血气图的５区。②确诊ＡＲＤＳ时血气指标在血气图上位于５区者病死率１００．０％，与其它区比较有显著性差异（Ｐ＜０．０５）。③患者随病情缓解，血气指标由６区转移至单纯通气过度区（３区）；４区首先转移至６区，再由６区转移至３区，其他患者仍在６区或４区，但向氧分压增高方向移动者获生存。患者随病情加重，血气指标由６区转移至４区，再由４区转移至５区，或４区转移至５区，５区患者进一步向低氧、高二氧化碳方?
OBJECTIVE: To improve the arterial blood gas map so that it can adapt to blood gas samples with different oxygen concentration and to study the performance and clinical significance of arterial blood gas in arterial blood gas diagram of patients with acute respiratory distress syndrome (ARDS). Methods: Under oxygen inhalation, arterial blood gas diagram as follows: ① The partial pressure of oxygen inhaled into the formula of alveolar gas to determine the concentration of oxygen in the alveolar carbon dioxide corresponding to the alveolar oxygen partial pressure; ② Depending on the Concentration of oxygen in alveolar arterial oxygen pressure difference to determine the concentration of oxygen, the corresponding partial pressure of alveolar carbon dioxide ideal arterial partial pressure of oxygen. Observe ARDS patients at diagnosis and before discharge changes in blood gas analysis. Results: (1) In the diagnosis of ARDS, the arterial blood gas indexes of patients were distributed on the blood gas chart as 8 cases of hyperventilation combined with ventilation (zone 6) and 3 cases of ventilation compensated ventilation (zone 4) 4 cases of combined ventilation damage area (5 districts), 5 cases of 6 districts and 1 patient of 4 districts were all in the 5th district of blood gas chart before death. (2) The CFR of ARDS was 100.0% in the 5th district in the blood gas chart, which was significantly different from other areas (P <0.05). ③ With the patient’s condition remission, the blood gas index was transferred from 6 districts to simple hyperventilation area (Area 3); 4 districts were transferred to 6 districts first, then 6 districts to 3 districts, other patients were still in 6 districts or 4 districts, Move to increase the partial pressure of oxygen to survive. With the aggravation of the patient’s condition, the blood gas index was transferred from Zone 6 to Zone 4, then from Zone 4 to Zone 5, or Zone 4 to Zone 5, and to Zone 5 to hypoxia and hypercapnia.