早期监测危重患者胃黏膜内pH值的临床意义  

Early clinical significance of the gastric intramucosal pH (pHi) on critical patients

作　　者：邢海波[1] 应利君[1] 

机构地区：[1]浙江省绍兴市人民医院ICU,浙江312000

出　　处：《江西医药》2006年第2期64-66,共3页Jiangxi Medical Journal

摘　　要：目的及时准确地评估危重患者组织缺氧及疾病的危重程度。方法将31例患者分为两组(其中存活组17例,死亡组14例),分别获得患者入ICU时及入ICU24h时胃黏膜内pH(pHi)值、SvO2、APACHEⅡ评分及PaO2/FiO2,将两组患者入ICU时及入ICU24h时的pHi测定结果分别与SvO2、APACHEⅡ评分及PaO2/FiO2结果作一比较。结果入ICU时两组间pHi差异已有显著性(P<0.05),死亡组pHi低于存活组,而两组间SvO2、APACHEⅡ评分及PaO2/FiO2差异无显著性(P>0.05);入ICU24h时两组间APACHEⅡ评分、SvO2差异才有显著性(P<0.01),而此时死亡组pHi更显著低于存活组(P<0.001),两组间PaO2/FiO2差异仍无显著性(P>0.05)。结论胃黏膜内pH(pHi)可更早期、更灵敏和准确地反映危重患者组织缺氧及疾病的危重程度。Objective To evaluate critical patients＇tissue anoxia and critical extent promptly and accuately. Menthods The critical patients＇gastric intramucosal pH （pHi） were measured immediately after being admitted and 24 hours later the SvO2, APACHE Ⅱ scores and PaO2/FiO2 were measured at the same time. All patients were divided into tow groups （the survivor17 and the dead 14）,then the gastric intramucosal pH were compared with the SvO2, APACHE Ⅱscores and PaO2/FiO2 between the tow groups. Results At admission time the phi in the dead group was lower than that of the survivor group（P〈0.05）,but the SvO2, APACHE Ⅱ scores and PaO2/FiO2 have no statistical significant difference between the dead group and the survivor group （P〉0.05）;24 hours later SvO2 and APACHE Ⅱ scores have statistical significant difference between the dead group and the survivor group （P〈0.01）, and yet the phi in the dead group was significant lower than in the survivor group （P〈0.001）.PaO2/FiO2 has no statistical significant difference between the dead group and the survivor group （P〉0.05）.Conclusion The gastric intramueosal pH can reflect critical patients＇ tissue anoxia and critical extent more early,sensitively and accuately.

关 键 词：胃黏膜内 pH(pHi) 缺氧 危重度 

分 类 号：R459.7[医药卫生—急诊医学]