摘要
目的探讨经皮氧分压(PctO_2)和经皮二氧化碳分压(PctCO_2)在不同微循环障碍新生儿诊断中的价值,分析其与PaO_2和PaCO_2的相关性。方法选择重症新生儿96例,依据毛细血管充盈时间不同,分为微循环正常组36例、轻度微循环障碍组30例和重度微循环障碍组30例。应用经皮氧/二氧化碳分压监测仪测定所有新生儿PctO_2和PctCO_2,并同步监测PaO_2和PaCO_2。分析各组患儿PctO_2、PctCO_2的表达水平有无差异,对PctO_2和PaO_2、PctCO_2和PaCO_2进行相关性分析;采用ROC曲线分析PctO_2、PctCO_2对新生儿缺氧及CO_2潴留的早期反应性。结果微循环正常组PctO_2和PaO_2、PctCO_2和PaCO_2均呈正相关(r=0.760和0.589,均P<0.01);轻度微循环障碍组和重度微循环障碍组PctCO_2和PaCO_2均呈正相关(r=0.728和0.698,均P<0.01),但PctO_2和PaO_2均无相关性(r=0.316和0.141,均P>0.05)。3组新生儿PctO_2表达均低于PaO_2,差异均有统计学意义(均P<0.01);但PctCO_2与PaCO_2比较差异均无统计学意义(均P>0.05)。微循环正常组、轻度微循环障碍组和重度微循环障碍组PctO_2与PctCO_2诊断缺氧和CO_2潴留的AUC依次为0.88(P=0.012)和0.65(P=0.112),0.58(P=0.348)和0.91(P=0.001),0.62(P=0.152)和0.89(P=0.008)。结论微循环正常新生儿经皮监测PctO_2和PctCO_2可较好替代PaO_2和PaCO_2;轻度及重度微循环障碍新生儿PctO_2不能较好反映PaO_2,此时需结合动脉血气指标综合判断。
Objective To analyze the correlation of percutaneous oxygen pressure （PctO2） and percutaneous carbondioxide pressure （PctCO2） with arterial blood gas indexes in neonatus with different microcirculation （MC） disturbance. MethodsNinety six critical neonates treated in NICU of Yongkang Maternal and Child Health Hospital from January 2016 to January 2017were enrolled. According to the capillary refill time （CRT） patients were divided into normal MC group（n=36）, mild MC disturbancegroup（n=30） and severe MC disturbance group（n=30）. The percutaneous blood gas indexes PctO2, PctCO2 and the arterial bloodgas indexes PaO2, PaCO2 were measured at the same time. The levels of PctO2 and PctCO2 were compared among the groups,the correlations between PctO2 and PaO2, between PctCO2 and PaCO2 were analyzed by Pearson analysis. The value of PctO2 andPctCO2 in assessing hypoxia and CO2 retention was analyzed by ROC curves. Results There were positive correlationsbetween PctO2 and PaO2 （r=0.760, P〈0.01） and between PctCO2 and PaCO2 （r=0.589, P〈0.01） in children with normal MC. Inchildren with mild or severe MC disturbance the PctCO2 was positively correlated with PaCO2 （r=0.728 and 0.698, both P〈0.01）,but PctO2 was not correlated with PaO2 （r=0.316 and 0.141, both P〉0.05）. The AUC on evaluating hypoxia and CO2 retention byPctO2 and PctCO2 in the normal, mild and severe MC disturbance were 0.88（P =0.012） and 0.65（P =0.112）, 0.58（P=0.348）and 0.91（P =0.001）, 0.62（P =0.152） and 0.89（P =0.008）, respectively. Conclusion The percutaneous blood gas indexes PctO2and PctCO2 can better replace arterial blood gas indexes PaO2 and PaCO2 in neonatus with normal MC. For neonatus with mild orsevere MC disturbance PaCO2 is correlated with PaCO2, while PctO2 can＇t reflect the changes of PaO2 and arterial blood gasanalysis is necessary.
出处
《浙江医学》
CAS
2018年第2期130-133,共4页
Zhejiang Medical Journal
