脓毒症患者周围动脉和中心静脉血气比较及其评价  

Evaluating and comparing between peripheral arterial and central venous blood gas in sepsis patients

作　　者：明自强[1] 俞林明[1] 吕银祥[1] 王黎卫[1] 吕少明[1] 

机构地区：[1]浙江省新昌县人民医院,浙江新昌312500

出　　处：《现代中西医结合杂志》2007年第24期3451-3452,共2页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的比较周围动脉血气和中心静脉血气评价脓毒症(Sepsis)患者酸碱状态的意义。方法60例脓毒症患者作为观察组,60例全麻术后生命体征稳定的患者作为对照组,分别检测2组患者周围动脉和中心静脉血气,比较2组动脉血和中心静脉血的pH值(pHa和pHv),动脉血和中心静脉血二氧化碳分压(pa(CO2)和pv(CO2),动脉血和中心静脉血氧分压(pa(O2)和pv(O2)),动-静脉血pH差值(AVpH),中心静脉血和动脉血pa(CO2)差值(VAp(CO2)。结果脓毒症患者在动脉血未出现酸中毒时静脉血已有明显的酸中毒表现,AVpH和VAp(CO2)较对照组明显升高,pv(CO2)上升,pv(O2)下降。2组的pHa、pa(CO2)、pa(O2)无显著性差异。结论为监测脓毒症患者组织内确切的酸碱状态,周围动脉血和中心静脉血必须同时进行检测。检测中心静脉血能较好地反映组织酸碱状态。Objective It is to evaluating and comparing between peripheral arterial and central venous blood gas in sepsis patients. Methods 60 patients of sepsis in the view group and 60 patients with steady vital sign after general anesthesia in control group, the blood gas of peripheral arterial and central venous was detected in both groups. The pH value （pHa and pHv） and p（CO2） （pa（CO2） and pv（CO2）） and p（O2）（pa（O2） and pv（O2）） and the difference of pH AtV （AVpH） and the difference of p（CO2） VtA （VAp（CO2）） were analyzed and compared. Results It was acid in central venous blood gas but was no acid in peripheral arterial blood gas, AVpH and VAp（CO2 ） were more higher than control group, and pv（CO2） was heightened, and pv（O2） was degraded. There were no significant difference in pHa, pa（CO2） and pa（O2） in both groups. Conclusion The samples of central venous blood in addition to the arterial blood should be required for the appropriate monitoring the acid- base composition in sepsis patients. The central venous blood gas is superior in the assessment of the acid- base status in these patients.

关 键 词：脓毒症 周围动脉血气 中心静脉血气 

分 类 号：R446.112[医药卫生—诊断学]