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PctO2和PctCO2在不同微循环障碍新生儿诊断中的价值及与动脉血气指标的相关性分析
程可萍, 陈卫园, 郎平
永康市妇幼保健院新生儿科
摘要:
目的探讨经皮氧分压(PctO2)和经皮二氧化碳分压(PctCO2)在不同微循环障碍新生儿诊断中的价值,分析其与PaO2和PaCO2的相关性。方法选择重症新生儿96例,依据毛细血管充盈时间不同,分为微循环正常组36例、轻度微循环障碍组30例和重度微循环障碍组30例。应用经皮氧/二氧化碳分压监测仪测定所有新生儿PctO2和PctCO2,并同步监测PaO2和PaCO2。分析各组患儿PctO2、PctCO2的表达水平有无差异,对PctO2和PaO2、PctCO2和PaCO2进行相关性分析;采用ROC曲线分析PctO2、PctCO2对新生儿缺氧及CO2潴留的早期反应性。结果微循环正常组PctO2和PaO2、PctCO2和PaCO2均呈正相关(r=0.760和0.589,均P<0.01);轻度微循环障碍组和重度微循环障碍组PctCO2和PaCO2均呈正相关(r=0.728和0.698,均P<0.01),但PctO2和PaO2均无相关性(r=0.316和0.141,均P>0.05)。3组新生儿PctO2表达均低于PaO2,差异均有统计学意义(均P<0.01);但PctCO2与PaCO2比较差异均无统计学意义(均P>0.05)。微循环正常组、轻度微循环障碍组和重度微循环障碍组PctO2与PctCO2诊断缺氧和CO2潴留的AUC依次为0.88(P=0.012)和0.65(P=0.112),0.58(P=0.348)和0.91(P=0.001),0.62(P=0.152)和0.89(P=0.008)。结论微循环正常新生儿经皮监测PctO2和PctCO2可较好替代PaO2和PaCO2;轻度及重度微循环障碍新生儿PctO2不能较好反映PaO2,此时需结合动脉血气指标综合判断。
关键词:  经皮二氧化碳分压 经皮氧分压 PaCO2 PaO2 微循环
DOI:10.12056/j.issn.1006-2785.2018.40.2.2017-1208
分类号:
基金项目:
Correlation of PctO2 and PctCO2 with arterial blood gas indexes in neonatus with different microcirculation disturbance
Yongkang Maternity and Child Care Hosptial
Abstract:
Objective To analyze the correlation of percutaneous oxygen pressure (PctO2) and percutaneous carbon dioxide pressure (PctCO2) with arterial blood gas indexes in neonatus with different microcirculation (MC) disturbance. Methods Ninety six critical neonates treated in NICU of Yongkang Maternal and Child Health Hospital from January 2016 to January 2017 were enrolled. According to the capillary refill time (CRT) patients were divided into normal MC group(n=36), mild MC disturbance group(n=30) and severe MC disturbance group(n=30). The percutaneous blood gas indexes PctO2, PctCO2 and the arterial blood gas indexes PaO2, PaCO2 were measured at the same time. The levels of PctO2 and PctCO2 were compared among the groups, the correlations between PctO2 and PaO2, between PctCO2 and PaCO2 were analyzed by Pearson analysis. The value of PctO2 and PctCO2 in assessing hypoxia and CO2 retention was analyzed by ROC curves. Results There were positive correlations between PctO2 and PaO2 (r=0.760, P<0.01) and between PctCO2 and PaCO2 (r=0.589, P<0.01) in children with normal MC. In children with mild or severe MC disturbance the PctCO2 was positively correlated with PaCO2 (r=0.728 and 0.698, both P<0.01), but PctO2 was not correlated with PaO2 (r=0.316 and 0.141, both P >0.05). The AUC on evaluating hypoxia and CO2 retention by PctO2 and PctCO2 in the normal, mild and severe MC disturbance were 0.88 (P =0.012) and 0.65 (P =0.112), 0.58(P=0.348) and 0.91(P =0.001), 0.62(P =0.152) and 0.89(P =0.008), respectively. Conclusion The percutaneous blood gas indexes PctO2 and PctCO2 can better replace arterial blood gas indexes PaO2 and PaCO2 in neonatus with normal MC. For neonatus with mild or severe MC disturbance PaCO2 is correlated with PaCO2, while PctO2 can't reflect the changes of PaO2 and arterial blood gas analysis is necessary.
Key words:  PctCO2 PctO2 PaCO2 PaO2 Microcirculation