【摘要】 目的:评价动静脉二氧化碳分压差(Pcv-a CO2)对组织氧供需平衡作用。方法:对本院2012年8月至2013年1月,行冠状动脉旁路移植术(CABG)82例患者,分别于术后入监护室即刻,12小时和24小时检测动静脉血气分析。分析Pcv-a CO2与中心静脉血氧饱和度(Scv O2)、动脉氧分压(Pa O2)相关性;比较术后并有呼吸、循环并发症患者对Pcv-a CO2、Scv O2、Pa O2、Sa O2及乳酸(Lac)值的影响。结果:Pcv-a CO2与Scv O2呈负相关(P<0.01),与Pa O2无相关性(P>0.05);并发症组较无并发症组Pcv-a CO2明显增高(P<0.01),Scv O2降低(P<0.05)。Pcv-a CO2平均值<8组并发症发生率明显减低(P<0.01),Scv O2平均值>70并发症发生率无明显减低(P>0.05)。结论:Pcv-a CO2和Scv O2较Pa O2,Sa O2和Lac能准确反映患者组织氧供需状态和组织损害程度,Pcv-a CO2较Scv O2敏感性更强,对判断组织缺氧损害程度具有较大临床指导价值。更多还原

【Abstract】 Objective: To investigated the value of Pcv-a CO2 on estimating oxygen supply and demand balance of coronary artery bypass graft( CABG) surgery. Methods: Pcv-a CO2,Scv O2,Pa O2,Sa O2 and Lac in 82 cases of CABG hospitalized between August 2012 to January 2013 were measured respectively at 0 hours,12 hours,24 hours after CABG. Comparing correlation between Pcv-a CO2 and Scv O2,Pa O2,Then studying the influence of Pcv-a CO2,Scv O2,Pa O2,Sa O2 and Lac on postoperative respiratory and circulatory complications in patients. Results: Pcv-a CO2 showed a negative correlation with Scv O2,and had no correlation with Pa O2,the value of Pcv-a CO2 of with postoperative respiratory and circulatory complications group was obviously increased( P < 0. 01) than that of without postoperative respiratory and circulatory complications group,while Scv O2decreased( P < 0. 05). The postoperative complications incidence of Group Pcv-a CO2< 8 was significantly lower,but that of Group Scv O2> 70 was not significantly reduce( P > 0. 05). Conclusion: Both Pcv-a CO2 and Scv O2 can estimate oxygen supply and demand balance of CABG obviously,and the Pcv-a CO2 can more accurate and sensitive than Scv O2.更多还原