【摘要】 目的:探讨脓毒症患者氧利用率(O2UC)的变化与预后关系。方法:60例危重病患者分为脓毒症组30例和非脓毒症组30例;另设30例正常人作为正常对照组。脓毒症组和非脓毒症组患者于急诊入院时及住院后1、2、3、5、7和10 d晨8时抽取股动脉和股静脉或锁骨下静脉血2 m l,查血气并计算O2UC。正常对照组仅查动、静脉血气1次,并计算O2UC(为动静脉血氧饱和度差/动脉血氧饱和度)。结果:患者急诊入院时和住院后1 d,脓毒症组和非脓毒症组O2UC均显著高于正常对照组(P均<0.01),而脓毒症组和非脓毒症组间差异无显著性(P>0.05)。当O2UC持续高于55%达12~24 h,患者预后极差,易于短期内死亡。从住院后2 d起,脓毒症组和非脓毒症组O2UC均很快下降,并低于正常对照组,且脓毒症组较非脓毒症组下降更加明显(P均<0.05)。非脓毒症组于住院后5 d起O2UC逐渐回升,并恢复至正常。而脓毒症组患者于住院后2 d起O2UC始终明显低于正常对照组(P均<0.01)。当O2UC持续低于21%时,提示合并症较多,预后不佳。结论:脓毒症患者常存在较低的O2UC,且病情严重、预后差。O2UC可作为脓毒症患者判断组织缺氧、病情严重程度和评估预后的有效指标。更多还原

【Abstract】 Objective: To investigate the relationship between prognosis and alteration of oxygen（utilization） coefficient（O₂UC） in patients with sepsis.Methods: Sixty critically ill patients were divided into（sepsis）（n=30） and nonsepsis（n=30） groups,and 30 healthy controls were selected as normal control group.Gas analysis of arterial blood and central venous blood and calculation of O₂UC（O₂UC=arterial oxygen（saturation-venous） oxygen saturation/arterial oxygen saturation） were carried out at 8 o′clock in sepsis and（non-sepsis） groups on admission and 1,2,3,5,7 and 10 days after admission,and gas analysis of arterial blood and central venous blood was carried out only once in the controls.Results: On admission and 1 day（after） admission,O₂UCs in sepsis and non-sepsis groups were significantly higher than that of control group（both P<0.01）,but O₂UC in sepsis group was not significantly different from that in non-sepsis group（（P>0.05））.When O₂UC in critically ill patients persisted higher than 55% for 12-24 hours,the prognosis of the patients was poor and had a tendency to die in a short time.From the 2 nd day after admission,O₂UCs in sepsis and non-sepsis groups were lower than that in control group,and O₂UC in sepsis group was obviously lower than that in non-sepsis group（all P<0.05）.From the 5 th day after admission,O₂UC in non-sepsis group elevated gradually and was not significantly different from that in control group（all P>0.05）,but from the 2 nd day after admission,O₂UC in sepsis group remained at a lower level compared with that in control group（all P<0.01）.When O₂UC in（patients） with sepsis persisted below 21% and maintained for a long time,there were more complications,higher mortality and poor prognosis in the patients.Conclusion: O₂UC in（patients） with sepsis is frequently lower,by which a more severe disease with poor prognosis can be（predicted）.O₂UC is an effective,sensitive and convenient predictor in monitoring and treating patients with sepsis.更多还原