【摘要】 目的:监测危重症患者足三里穴内组织氧变化,评估危重症,尤其是重症感染患者局部组织氧合状态,探讨经穴组织氧测定法在临床上的应用价值。方法:将36例有创机械通气的危重症患者分为感染组(13例)和非感染组(23例)。测定吸氧浓度(FiO2)为0.40时患者右下肢足三里穴内组织氧分压(PtO2),同时检测其动脉血气、体温、心率、血压、血红蛋白,计算PtO2指数(PtO2/PaO2比值)。结果:感染组的心率显著高于非感染组,而PaO2显著低于非感染组;在此情况下,感染组的PtO2指数、PtO2反而显著升高,尤其是PtO2指数升高更明显(P均<0.05)。结论:重症感染危重症患者在全身性氧输送有障碍的情况下,经穴局部组织的氧需求仍显著增加;经穴组织可能通过显著提高PtO2指数来满足自身异常增高的氧需求。用经穴组织氧测定法监测危重症局部组织氧合状况有十分重要的临床指导意义。更多还原

【Abstract】 Objective: To evaluate the local tissue oxygenation of the critically and severely ill patients, especially patients suffering from severe infections by monitoring the change of tissue oxygen in Zusanli point（足三里穴, point ST36） and to discuss the value of acupoint tissue oxygen determination in clinical applications. Methods: Thirtysix critically ill patients under invasive positive pressure ventilation （IPPV） were divided into infection group （13 cases） and noninfection group （23 cases）. Domestically made twopassage tissue oxygen tension determinator was used to determine the tissue oxygen tension （PtO₂） in Zusanli point of the right lower limb when the fraction of inspired oxygen （FiO₂） was 0.40. Meanwhile, the arterial blood gas （ABS）, body temperature, heart rate, blood pressure and hemoglobin were also tested, and PtO₂ index 〔ratio of PtO₂/partial pressure of oxygen in arteryratio （PaO₂）〕 was calculated. Results: The heart rate was significantly higher, and PaO₂ was significantly lower in the infection group than that in the non infection group. On the contrary, the PtO₂ index and PtO₂ went up significantly, especially the PtO₂ index （ both P<0.05） in the infection group. Conclusion: When the critically ill patients suffering from severe infection are unable to receive systemic oxygen delivery, the oxygen demand of acupoints in local tissues still increases significantly. The acupoint tissue may satisfy its own abnormally increased oxygen demand through significant improvement of the PtO₂ index. It is of great significance to use the acupoint tissue oxygen determination to determine the local tissue oxygenation state of the critically and severely ill patients.更多还原