改良氧利用率在心脏停跳后自主循环恢复早期阶段的变化研究  

Modified oxygen utilization coefficient (MO_2UC)variation during the early period after the restoration of spontaneous circulation

作　　者：何忠杰[1] 任国军 柯友洋[3] 陈东[4] 张宪[1] 彭国球[1] 赵晓东[1] 党伟[1] 马俊勋[1] 刘波[1] 陈春鸣[1] 袁晓玲[1] 

机构地区：[1]中国人民解放军总医院304急救部,北京100037 [2]内蒙古呼和浩特准格尔煤矿总医院ICU,内蒙古呼和浩特010300 [3]中国人民解放军171医院急救中心,江西九江332000 [4]辽宁阜新市公安医院急诊部,辽宁阜新123000

出　　处：《中国急救医学》2005年第4期237-240,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的利用改良氧利用率(MO2UC)指标对心肺复苏期间自主循环恢复早期的氧代谢进行监测研究。方法前瞻性地监测10例心肺复苏病人复苏中的动脉及相关静脉血气,计算MO2UC,并进行动态观察。结果①成活组MO2UC为0.31±0.08,死亡组MO2UC为0.71±0.25,有显著性差异( P<0 001)。②复苏结果比较无任何效果3例死亡,其MO2UC变化呈现出高值或上升趋势(MO2UC=0.82±0.16)。自主循环恢复2 例,最终死亡,其MO2UC呈下降趋势(MO2UC=0.50±0 29)。自主循环、呼吸、意识恢复5例,其MO2UC为0.31±0.08。结论①可用MO2UC-循环状态对心肺复苏进行四分期大循环恢复、微循环障碍或(和)细胞氧利用抑制、细胞氧代谢恢复和偿还组织氧债、恢复正常。②MO2UC曲线的变化还可以作为病人危重程度的预警指标。Objective To evaluate the role of modified oxygen utilization coefficient (MO_2UC =(SaO_2-SvO_2)/SaO_2)variation during the early period after the restoration of spontaneous circulation(ROSC). Methods 10 patients [male 8,femal 2,ages:23～74(49.4±16.0) years] were resuscitated by the closed chest cardiac massage (the frequency of massage was 110～140 beat/min).We observed simultaneously blood gas of interjugular venous or central venous catheter and artery to calculate the MO_2UC during cardiopulmonary resuscitation and the early period of ROSC. Results ①Survival group′s MO_2UC was 0.31±0.08;death group was 0.71±0.25(P<0.001),there were significant difference.②result of CPR: 3 cases without ROSC, their MO_2UC=0.82±0.16 had increasing tendency. 2 cases with ROSC died, their MO_2UC=0.50±0.29, and had decreasing tendency but beyond normal range. 5 cases without brain damage ,were alive their MO_2UC= 0.31±0.08.Conclusion MO_2UC-Circulation status can be used to predict the progress of illness. The typical MO_2UC-Circulation status show the early 4 stages of CPR in human body: the first stage is restoration of large circulation (5～30 mins); The second stage is dysfunction of microcirculation and suppressive status of oxygen metabolism (0.5～2 hours);The third stage is restoration of tissue oxygen metabolism and repayment of the oxygen debt (2～4 hours); The fourth stage is normal range of oxygen metabolism(4～6 hours). [

关 键 词：改良氧利用率 氧利用率 氧代谢 心肺复苏 白金10分钟 

分 类 号：R459.7[医药卫生—急诊医学]