动-静脉二氧化碳分压监测对组织氧供需平衡的评价  

The value of Pcv-aCO2 on estimating oxygen supply and demand balance

作　　者：仇杰[1] 刘宏生[1] 褚衍林[1] 李清贤[2] 王彦富[2] 张春英[1] 刘高利[1] 李祥[1] 

机构地区：[1]济宁医学院附属医院心脏外科ICU,山东207029 [2]济宁医学院附属医院心血管内科,山东207029

出　　处：《心肺血管病杂志》2014年第6期838-840,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：济宁市科技发展项目(2013jnwk45)

摘　　要：目的:评价动静脉二氧化碳分压差(Pcv-a CO2)对组织氧供需平衡作用。方法:对本院2012年8月至2013年1月,行冠状动脉旁路移植术(CABG)82例患者,分别于术后入监护室即刻,12小时和24小时检测动静脉血气分析。分析Pcv-a CO2与中心静脉血氧饱和度(Scv O2)、动脉氧分压(Pa O2)相关性;比较术后并有呼吸、循环并发症患者对Pcv-a CO2、Scv O2、Pa O2、Sa O2及乳酸(Lac)值的影响。结果:Pcv-a CO2与Scv O2呈负相关(P<0.01),与Pa O2无相关性(P>0.05);并发症组较无并发症组Pcv-a CO2明显增高(P<0.01),Scv O2降低(P<0.05)。Pcv-a CO2平均值<8组并发症发生率明显减低(P<0.01),Scv O2平均值>70并发症发生率无明显减低(P>0.05)。结论:Pcv-a CO2和Scv O2较Pa O2,Sa O2和Lac能准确反映患者组织氧供需状态和组织损害程度,Pcv-a CO2较Scv O2敏感性更强,对判断组织缺氧损害程度具有较大临床指导价值。Objective：To investigated the value of Pcv-aCO2 on estimating oxygen supply and demand balance of coronary artery bypass graft （CABG） surgery. Methods： Pcv-aCO2, ScvO2, PaO2, SaO2 and Lae in 82 cases of CABG hospitalized between August 2012 to January 2013 were measured respectively at 0 hours, 12 hours, 24 hours after CABG. Comparing cmTelation between Pcv-aCO2 and ScvO2 , PaO2 , Then studying the influence of Pcv-aCO2 , ScvO2, PaO2 , SaO2 and Lac on postoperative respiratory and circulatory complications in patients. Results ： Pcv-aCO2 showed a negative correlation with ScvO2 , and had no correlation with PaO2 , the value of Pcv-aCO2 of with postoperative respiratory and circulatory complications group was obviously increased （P 〈0. 01 ） than that of without postoperative respiratory and circulatory complications group, while ScvO2 decreased （P 〈 0. 05 ）. The postoperative complications incidence of Group Pcv-aCO2 〈 8 was significantly lower, but that of Group ScvO2 〉 70 was not significantly reduce（ P 〉 0. 05 ）. Conclusion： Both Pcv-aCO2 and ScvO2 can estimate oxygen supply and demand balance of CABG obviously, and the Pev-aCO2 can more accurate and sensitive than ScvO2.

关 键 词：动-静脉二氧化碳分压差 中心静脉血氧饱和度 冠状动脉旁路移植术 血气分析 乳酸 

分 类 号：R54[医药卫生—心血管疾病]