经皮二氧化碳分压及氧分压监测在新生儿重症监护病房的应用价值探讨  

A study on the value of transcutaneous carbon dioxide / oxygen monitoring in NICU

作　　者：任艳丽[1] 杨长仪[1] 陈涵强[1] 杨斌[1] 林华川[1] 郑歆婷[1] 

机构地区：[1]福建医科大学教学医院 福建省妇幼保健院新生儿科,福州350000

出　　处：《中国新生儿科杂志》2015年第2期98-103,共6页Chinese Journal of Neonatology

摘　　要：目的探讨经皮二氧化碳分压及氧分压检测在新生儿重症监护病房（NICU）的应用价值。方法将2012年12月至2013年4月入住我科的新生儿作为研究对象,按照入院病情纳入呼吸障碍组、循环障碍组、呼吸循环功能正常组和极低出生体重儿组。监测各组动脉血气、经皮二氧化碳分压（Tc PCO2）、经皮氧分压（Tc PO2）及经皮血氧饱和度（Tc Sa O2）;比较Tc PCO2及Tc PO2检测结果与动脉血气分析结果之间的相关程度。结果呼吸障碍组115例,循环障碍组15例,呼吸循环功能正常组55例。呼吸障碍组、循环障碍组和极低出生体重儿Tc PCO2与Pa CO2具有较好的相关性和一致性,相关系数及其95%可信区间分别为r=0.766,95%CI 0.678-0.832;r=0.921,95%CI 0.774-0.974;r=0.874,95%CI 0.750-0.939,P均〈0.05。Tc PO2与Pa O2在极低出生体重儿相关性好（r=0.827,P〈0.05）,在呼吸障碍组（r=0.602,P〈0.05）及呼吸循环功能正常组（r=0.599,P〈0.05）相关性较弱,在循环障碍组无相关性（P〉0.05）。Tc Sa O2与Pa O2有较好的相关性（r=0.677,P〈0.05）,但不能体现高氧分压。结论 Tc PCO2测定在呼吸障碍、循环障碍患儿和极低出生体重儿具有连续、无创的优点,可以预测Pa CO2;综合Tc PO2和Tc Sa O2可以较真实地反映患儿的氧合情况。Objective To study the value of transcutaneous carbon dioxide /oxygen monitoring in NICU. Methods A total of 185 neonates were recruited into the study from December 2012 to April2013 and assigned into four groups（ respiratory dysfunction group,circulatory dysfunction group,normal group, and very low birth weight group）. Transcutaneous carbon dioxide / oxygen pressure（ Tc PCO2/ Tc PO2） was monitored. In comparison,simultaneous partial pressure of carbon dioxide /oxygen（ Pa CO2/ Pa O2） of arterial blood gas and transcutaneous oxygen saturation（ Tc Sa O2） were measured and their correlation analyzed. Results Total of 115 cases were recruited in respiratory dysfunction group,15 in circulatory dysfunction group and 55 in normal group. The correlation was strong between Tc PCO2 and Pa CO2 in respiratory dysfunction group,circulatory dysfunction group and very low birth weight（ VLBW） infants [r = 0. 766,P〈0. 05,95% CI 0. 678- 0. 832; r = 0. 921,P〈0. 05,95% CI0. 774- 0. 974; r = 0. 874,P〈0. 05,95% CI 0. 750- 0. 939]. The correlation was strong between Tc PO2 and Pa O2 in VLBW infnts（ r = 0. 827, P〈0. 05）, and weak in respiratory dysfunction group（ r = 0. 602,P〈0. 05） and normal group（ r = 0. 599,P〈0. 05）. In addition,Tc PO2 and Pa O2 in circulatory dysfunction group showed no correlation（ P〈0. 05）. The correlation of Tc Sa O2 and Pa O2 was strong（ r = 0. 677,P〈0. 05）,but Tc Sa O2 can not reflect the extent of hyperoxemia. Conclusions Transcutaneous CO2 monitoring is a continuous and noninvasive technology. It can be used as a valuable complement of Pa CO2. The combination of transcutaneous oxygen pressure and Tc Sa O2 can be a true reflection of oxygenation in infants.

关 键 词：血气分析 血气监测 经皮 重症监护病房 新生儿 

分 类 号：R722.1[医药卫生—儿科]