【摘要】 目的　探讨多器官功能障碍综合征 (MODS)患者氧利用率的变化与预后的关系。方法　①将 71例危重病人分为合并MODS组 (A组、 34例 )、未合并MODS组 (B组 ,37例 ) ;另设正常人对照组(C组 ,30例 )。②A、B组患者于急诊入院和住院后 1 ,2 ,3,5 ,7,1 0d分别于 8∶0 0时抽动静脉血查血气并计算氧利用率。C组仅做动静脉血气 1次并计算氧利用率。结果　①急诊入院时和住院第 1天 ,A、B组的氧利用率 [A组 :(0 4 38± 0 0 882 )和 (0 4 2± 0 0 73) ;B组 :(0 4 0 71± 0 0 979)和 (0 3974± 0 0 871 ) ]均显著高于C组 [(0 31 1 4± 0 0 4 0 4 ) ,P <0 0 1 ],而A、B组差异无显著性意义 (P >0 0 5 )。当氧利用率持续高于 0 5 5达 1 2～ 2 4h ,病人预后极差 ,易于短期内死亡。②从住院第 2天起 ,A、B组氧利用率均很快速下降 ,并低于C组 (P <0 0 5 ) ,且A组较B组下降更明显 (P <0 0 5 )。B组于住院第 5天起氧利用率逐渐回升 ,并恢复正常。而A组病人于第 2天起 ,氧利用率始终明显低于C组 (P <0 0 1 )。当氧利用率持续低于0 2 1时 ,提示合并症较多 ,预后不佳。结论　MODS患者常存在较低的氧利用率 ,且病情严重、预后差。氧利用率可作为判断危重病人组织缺O2 ,病情严重程度和评估预后的有效指标更多还原

【Abstract】 Objective To investigate relationship between prognosis and alteration oxygen utilization coefficient(O 2UC)in patients with multiple organ dysfunction syndrome(MODS).Methods ①71 critical stressed patients were subdivided into Group with MODS(Group A,patients of 34)and Group without MODS(Group B,patients of 37),and 30 normal subject group(Group C)were selected for comparism.②Gas analysis of arterial boold and central venous blood and calcuation of O 2UC [O 2UC=(SaO 2-SvO 2)/SaO 2]were carried out in group A and group B on admission and 1,2,3,5,7,10days after admission,and witch was carried out only in group C.Results ①On admission and 1 day after admission,O 2UC in group A(0 438±0 0882 and 0 42±0 073)and group B(0 4071±0 0979 and 0 3974±0 0871)were significantly higher than that of group C(0 3114±0 0404),(P<0 01),but O 2UC in group A were not significantly different from those in group B(P>0 05).When O 2UC in critical patients persisted high 0 55 for a long time(12～24 hours),the prognosis of the patients was bad.②From beginning with 2 days after admission,O 2UC in group A and group B were lower than that in group(P<0 05),adn O 2UC in group A were obviously lower that those in group B(P<0 05 or P<0 01).From 5days after admission,O 2UC in group B were then improve and were not significantly different from that in group C(P>0 05),but O 2UC in group A remained at a lower level (compared with group C,P<0 01).Wehn O 2UC in patients with MODS persisted to decrease below 0 21 and maintained for a long time,there were higher severity of disease,higher death rate and the prognosis of the patients was bad also.Conclusion O 2UC in patients with MODS is frequently lower.This predicts more severe disease,wores prognosis.O 2UC is a effective,sensible and convenient predictor in the monitor and treatment of critical patients. [更多还原