足三里穴内组织氧监测在危重症中的应用  

Application of monitoring tissue oxygen tension in Zusanli point(足三里穴) in critically ill patients

作　　者：邓杰[1] 王明明[1] 沈芝红[1] 陈学波[1] 

机构地区：[1]浙江省舟山市人民医院ICU,浙江舟山316004

出　　处：《中国中西医结合急救杂志》2005年第4期233-235,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省舟山市卫生局资助项目(2003104)

摘　　要：目的:监测危重症患者足三里穴内组织氧变化,评估危重症,尤其是重症感染患者局部组织氧合状态,探讨经穴组织氧测定法在临床上的应用价值。方法:将36例有创机械通气的危重症患者分为感染组(13例)和非感染组(23例)。测定吸氧浓度(FiO2)为0.40时患者右下肢足三里穴内组织氧分压(PtO2),同时检测其动脉血气、体温、心率、血压、血红蛋白,计算PtO2指数(PtO2/PaO2比值)。结果:感染组的心率显著高于非感染组,而PaO2显著低于非感染组;在此情况下,感染组的PtO2指数、PtO2反而显著升高,尤其是PtO2指数升高更明显(P均<0.05)。结论:重症感染危重症患者在全身性氧输送有障碍的情况下,经穴局部组织的氧需求仍显著增加;经穴组织可能通过显著提高PtO2指数来满足自身异常增高的氧需求。用经穴组织氧测定法监测危重症局部组织氧合状况有十分重要的临床指导意义。Objective： To evaluate the local tissue oxygenation of the critically and severely ill patients,especially patients suffering from severe infections by monitoring the change of tissue oxygen in Zusanli point（足三里穴, point ST36） and to discuss the value of acupoint tissue oxygen determination in clinical applications. Methods： Thirty- six critically ill patients under invasive positive pressure ventilation （IPPV）were divided into infection group （13 cases） and non- infection group （23 cases）. Domestically made two- passage tissue oxygen tension determinator was used to determine the tissue oxygen tension （PtO2） in Zusanli point of the right lower limb when the fraction of inspired oxygen （FiO2） was 0. 40. Meanwhile, the arterial blood gas （ABS）, body temperature, heart rate, blood pressure and hemoglobin were also tested, and PtO2 index [ratio of PtO2/partial pressure of oxygen in arteryratio （PaO2）] was calculated. Results： The heart rate was significantly higher, and PaO2 was significantly lower in the infection group than that in the noninfection group. On the contrary, the PtO2 index and PtO2 went up significantly, especially the PtO2 index（both P〈C0.05） in the infection group. Conclusion： When the critically ill patients suffering from severe infection are unable to receive systemic oxygen delivery, the oxygen demand of acupoints in local tissues still increases significantly. The acupoint tissue may satisfy its own abnormally increased oxygen demand through significant improvement of the PtOz index. It is of great significance to use the acupoint tissue oxygen determination to determine the local tissue oxygenation state of the critically and severely ill patients.

关 键 词：危重症 感染 足三里 经穴 组织氧分压 

分 类 号：R246[医药卫生—针灸推拿学]