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目的探讨经皮二氧化碳分压及氧分压检测在新生儿重症监护病房(NICU)的应用价值。方法将2012年12月至2013年4月入住我科的新生儿作为研究对象,按照入院病情纳入呼吸障碍组、循环障碍组、呼吸循环功能正常组和极低出生体重儿组。监测各组动脉血气、经皮二氧化碳分压(Tc PCO2)、经皮氧分压(Tc PO2)及经皮血氧饱和度(Tc Sa O2);比较Tc PCO2及Tc PO2检测结果与动脉血气分析结果之间的相关程度。结果呼吸障碍组115例,循环障碍组15例,呼吸循环功能正常组55例。呼吸障碍组、循环障碍组和极低出生体重儿Tc PCO2与Pa CO2具有较好的相关性和一致性,相关系数及其95%可信区间分别为r=0.766,95%CI 0.678~0.832;r=0.921,95%CI 0.774~0.974;r=0.874,95%CI 0.750~0.939,P均<0.05。Tc PO2与Pa O2在极低出生体重儿相关性好(r=0.827,P<0.05),在呼吸障碍组(r=0.602,P<0.05)及呼吸循环功能正常组(r=0.599,P<0.05)相关性较弱,在循环障碍组无相关性(P>0.05)。Tc Sa O2与Pa O2有较好的相关性(r=0.677,P<0.05),但不能体现高氧分压。结论 Tc PCO2测定在呼吸障碍、循环障碍患儿和极低出生体重儿具有连续、无创的优点,可以预测Pa CO2;综合Tc PO2和Tc Sa O2可以较真实地反映患儿的氧合情况。
Objective To investigate the value of percutaneous carbon dioxide partial pressure and partial pressure of oxygen in neonatal intensive care unit (NICU). Methods Newborns admitted to our department from December 2012 to April 2013 were enrolled in the study. The patients were divided into the group of respiratory disorder, circulatory disturbance, normal respiratory function and very low birth weight infants according to the admission condition. The arterial blood gas, Tc PCO2, Tc PO2 and Tc Sa O2 were measured in each group. The results of Tc PCO2 and Tc PO2 were compared with arterial blood gas analysis The correlation between the results. Results There were 115 cases of respiratory disorder, 15 cases of circulatory disturbance and 55 cases of normal respiratory cycle. There was a good correlation and agreement between Tc PCO2 and PaCO2 in respiratory disorder group, circulatory disturbance group and very low birth weight infants, the correlation coefficient and 95% confidence interval were r = 0.766, 95% CI 0.678-0.832, respectively; r = 0.921, 95% CI 0.774-0.974; r = 0.874, 95% CI 0.750-0.939, all P <0.05. The correlation between Tc PO2 and Pa O2 in very low birth weight children was significant (r = 0.827, P <0.05). In the group of respiratory disorder (r = 0.602, P <0.05) 0.05), but no correlation in the circulatory disturbance group (P> 0.05). There was a good correlation between Tc Sa O2 and Pa O2 (r = 0.677, P <0.05), but not the high partial pressure of oxygen. Conclusions The Tc PCO2 assay has the advantages of continuous and noninvasive detection in Pairs of children with respiratory disorders, circulatory disorders and very low birth weight. PaCO2 can be predicted. Combined Tc PO2 and Tc Sa O2 can reflect the oxygenation status of children more accurately.