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目的 :评价氧疗患儿经皮氧分压(TcPO_2)及二氧化碳分压(TcPCO_2)与动脉血氧分压(PaO_2)及二氧化碳分压(PaCO_2)的一致性及其影响因素,为无创监测在氧疗新生儿中的应用提供初步的指导依据。方法:收集氧疗新生儿的动脉血气值,并记录采集前后5 min内TcPO_2及TcPCO_2的平均值、体重、胎龄、脉搏(P)、吸入氧浓度、动脉血氧饱和度(SaO_2)、pH等,进行Pearson相关分析并运用受试者工作曲线(ROC)判断诊断价值。结果 :体重、吸入氧浓度等对TcPCO_2与PaCO_2在氧疗患儿中的相关性及一致性影响较小,循环障碍组TcPCO_2明显高于PaCO_2;TcPO_2与PaO_2的相关性稍差,在氧合指数较低及较高组两者无统计学相关,两者的差值随着出生体重的增大及动脉氧分压的增大而增加。结论:TcPCO_2与PaCO_2具有较好的相关性及一致性,尤其在极低出生体重儿,而TcPO_2与PaO_2相关性及一致性稍差,对于氧疗患儿,高氧分压下TcPO_2与PaO_2缺乏很好的相关性,在肺部氧合较差却无呼吸障碍表现时TcPO_2比PaO_2更能反映患儿的动脉氧合,对于指导氧疗新生儿的用氧更有价值。
OBJECTIVE: To evaluate the consistency and influencing factors of percutaneous oxygen pressure (TcPO_2), TcPCO_2 and PaCO_2 and PaCO_2 in patients with oxygen therapy. Oxygen therapy in neonatal applications provide a preliminary guide. Methods: Arterial blood gas was collected from neonates undergoing oxygen therapy. The mean values of TcPO_2 and TcPCO_2, body weight, gestational age, pulse (P), inspired oxygen, arterial oxygen saturation (SaO_2) , Pearson correlation analysis and the use of receiver operating characteristic curve (ROC) to determine the diagnostic value. Results: The body weight and inspired oxygen concentration had little effect on the correlation and consistency between TcPCO_2 and PaCO_2 in children with oxygen therapy. The TcPCO_2 in circulatory disturbance group was significantly higher than that in PaCO_2. The correlation between TcPO_2 and PaO_2 was slightly worse. The difference between the two groups was not statistically significant. The difference between the two groups increased with the increase of birth weight and arterial partial pressure of oxygen. Conclusion: TcPCO_2 and PaCO_2 have good correlation and consistency, especially in very low birth weight infants, while the correlation and consistency between TcPO_2 and PaO_2 are slightly worse. For oxygen therapy, TcPO_2 and PaO_2 are deficient Very good correlation between TcPO2 and PaO2 could better reflect the arterial oxygenation in children with poor oxygenation in the lungs but no respiratory disturbance.