动脉血气分析电子计算辅助判读的设计与应用:附二例案例分析  

Design and application of arterial blood gas analysis assisted by electronic computation:analysis of two cases attached

作　　者：吴杰斌[1] 吴子健 翟敬芳[3] 周彬[1] Wu Jiebin;Wu Zijian;Zhai Jingfang;Zhou Bin(Department of Neonatology,Xuzhou Center Hospital,Xuzhou Clinical School of Nanjing Medical University,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院南京医科大学徐州临床学院新生儿科,221009 [2]中国矿业大学徐海学院计算机科学与技术专业,徐州221008 [3]徐州市中心医院南京医科大学徐州临床学院产前诊断中心,221009

出　　处：《中国小儿急救医学》2022年第8期635-640,共6页Chinese Pediatric Emergency Medicine

基　　金：徐州市科学技术局重点研发计划项目(KC18185);江苏省妇幼健康科研项目(F201942)。

摘　　要：目的:制作动脉血气分析判读Excel电子表格,快速准确判断酸碱失衡类型,以指导临床处理酸碱紊乱。方法:依据Henderson-Hasselbalch方程式以及酸碱失调预计代偿公式,参考酸碱平衡理论和研究进展,整理酸碱失衡分析流程,使用Microsoft Office Excel 2003中IF函数编辑公式制作动脉血气分析判读Excel电子表格,输入pH值、动脉血二氧化碳分压(PaCO 2)、实际碳酸氢根(HCO 3-)、钠离子(Na +)、氯离子(Cl -)和代偿时限相关参数,即可自动显示酸碱失衡类型。对徐州市中心医院重症监护室185例次的动脉血气分析分别进行Excel电子表格组与人工组判断,对酸碱失衡类型判断结果及判断时间进行比较。 结果:两组酸碱失衡类型判断结果进行比较,正常及单纯型酸碱失衡42例,一致率100%;双重性酸碱失衡107例,一致率97.20%;三重酸碱失衡36例,一致率91.67%。经Kappa一致性检验,Kappa值=0.944;配对卡方检验(McNemar-Bowker Test),两组判断结果一致性好( P=0.223)。Excel电子表格组判断时间明显少于人工组[正常或单纯型酸碱失衡:(32.32±4.26)s比(75.88±19.22)s,双重性酸碱失衡:(31.28±5.31)s比(137.56±37.64)s,三重酸碱失衡:(32.98±4.23)s比(315.09±89.37)s],差异均有统计学意义( P均<0.01)。 结论:动脉血气分析判读Excel电子表格,界面简洁,操作简单,能快速准确地对动脉血气分析进行酸碱失衡类型的判断,尤其对三重酸碱失衡更具有优势,能避免pH 7.35~7.45时酸碱失衡类型的漏判。Objective To make Excel spreadsheet of arterial blood gas analysis to judge the types of acid-base imbalance quickly and accurately,and guide the clinical treatment of acid-base disorders.Methods According to the Henderson-Hasselbalch equation,the compensation formula of acid-base imbalance prediction,the theory of acid-base balance and the related research progress,the analysis process of acid-base balance disorder was settled,and the IF function in Microsoft Office Excel 2003 was used to edit the formula to make Excel spreadsheet for arterial blood gas analysis.Once the pH value,artery blood carbon dioxide pressure(PaCO2),actual bicarbonate(HCO3-),sodiumion(Na+),chlorineion(Cl-)and compensatory time-limited parameters were input,the types of acid-base imbalance can be shown.Arterial blood gas analysis of 185 cases from intensive care unit at Xuzhou Central Hospital was determined by Excel spreadsheet group and manual group respectively,the results and time of judging the type of acid-base imbalance were compared between two groups for statistical analysis.Results The results of acid-base imbalance between two groups were compared,and 42 cases were normal and simple acid-base and the consistent rate was 100%,double acid-base imbalances of 107 cases with the consistent rate of 97.20%,triple acid-base imbalances of 36 cases with the consistent rate of 91.67%.After Kappa consistency test(Kappa value=0.944)and Pair chi-square Test(McNemar-Bowker Test)(P=0.223),the results of two groups were consistent.It took less time to judge the results of normal or simple acid-base imbalance[(32.32±4.26)s vs.(75.88±19.22)s],double acid-base imbalance[(31.28±5.31)s vs.(137.56±37.64)s]and triple acid-base imbalance[(32.98±4.23)s vs.(315.09±89.37)s]by the Excel spreadsheet group compared with the manual group,and the differences were statistically significant(P<0.01).Conclusion The automatic judging of Excel spreadsheet for arterial blood gas analysis can quickly and accurately determine the types of acid-base imbalance in ar

关 键 词：EXCEL电子表格 血气分析 酸碱失衡 计算机分析 

分 类 号：R446.11[医药卫生—诊断学]