【摘要】 目的 :改进动脉血气图 ,使之适用于吸氧患者 ,并观察支气管哮喘急性发作期动脉血气指标在动脉血气图上的表现 ,研究其临床意义。方法 :将动脉血气图横坐标由 PO2 改为 PO2 / Fi O2 ,纵坐标 (PCO2 )标出不同吸氧浓度时 PCO2 理论最大值。观察 5 1例支气管哮喘患者动脉血气指标在血气图上的变化。结果 :1来院时血气指标分区 :单纯通气过度区 (3区 ) 1例 ,通气过度换气损害区 (6区 ) 2 8例 ,通气代偿换气损害区 (4区 ) 13例 ,通气不足换气损害区 (5区 ) 9例。 2 5 1例患者病情严重程度与分区的关系 :3例轻度患者中 1例 3区 ,另 2例 6区 ;2 9例中度患者中 9例 4区 ,另 2 0例 6区 ;14例重度患者中 4例 4区、6例 6区和 4例 5区 ;5例危重患者均在 5区。 3病情缓解时 :轻度患者由 6区→ 3区→ 1区 ,中度患者由 4区→ 6区→ 1区 ,重度和危重患者由 5区→4区→ 6区。 4病情加重时 :由 6区→ 4区→ 5区 ,病情越重 ,越向血气图的左上方移动 (高 CO2 和低 O2 )。结论 :动脉血气图可作为判断病情严重程度的依据之一 ,对治疗方法选择、疗效观察和预后估计有一定的临床意义更多还原

【Abstract】 Objective:To modify the arterial blood gases graph (ABGG) so that it can be used in patients inhaling supplemental oxygen in different concentrations,and to study the variations of arterial blood gases parameters (ABGPs) in patients with asthma exacerbation to assess their clinical significance.Methods:In the new ABGGs,partial pressure of oxygen(PO 2)/FiO 2 was used instead of PO 2 in the old ABGG.The variations in ABGPs of asthma exacerbation were observed.Results:①At the acute onset of asthma,the ABGPs were in the area of hyperventilation alone (area 3) in 1 case,in the area of compensated ventilation and damaged gaseous exchange (area 4) in 13 cases,in the area of insufficient ventilation and damaged gaseous exchange (area 5) in 9 cases,and in the area of hyperventilation and damaged gaseous exchange (area 6) in 28 cases.②The relatiohship between the severity of 51 asthma exacerbation and the area of ABGG was as follows:among 3 mild patients,1 case belonged to the area 3,2 cases were in the area 6;among 29 moderate patients 9 cases fell in the area 4 and 20 cases in the area 6;among 14 severe patients 4 cases were in the area 4,4 cases in the area 5 and 6 cases in the area 6;among 5 patients with imminent respiratory arrest all of them were in the area 5.③When the patient′s condition improved,the ABGPs of mild patients shifted from the area 6 through the area 3 to the area 1;those of moderate patients from the area 4 through the area 6 to the area 1;those of severe and respiratory arrest imminent patients from the area 5 through the area 4 to the area 6.④When the patient′s condition became worse,the ABGPs shifted from the area 6 through the area 4 to the area 5.Conclusions:The ABGG can be taken as an indicator to determine the severity of asthma exacerbation.It is useful in selection of treatment,guidance of treatment and assessment of prognosis in patients with asthma exacerbation.更多还原