摘要
目的 探讨烧伤脓毒症患者的氧供、氧耗、氧摄取率特点及其变化与临床转归的关系。方法 对 1993年 3月～ 1998年 9月收治的烧伤脓毒症患者 32例进行Swan Ganz漂浮导管监测 ,并根据同时间点的动、静脉血氧分压、氧饱和度、血红蛋白 ,计算氧供、氧耗量及氧摄取率。结果 脓毒症出现后 ,氧供、氧耗及氧摄取率明显增加 ,随病情好转 ,氧供、氧耗量及氧摄取率逐步恢复 ,但观察期内仍高于正常水平 ;而并发MODS患者首先表现为氧供量增加 ,但氧耗量及氧摄取率低于单纯脓毒症病人 ,出现氧耗量脱离氧供的假象 ,机体酸中毒显著。脓毒症并发MODS死亡患者临终前氧供、氧耗量、氧摄取率均低于成活者。结论 高代谢是烧伤和脓毒症患者的临床表现之一。因此 ,保证机体充足氧供、减少氧耗量、提高组织细胞氧摄取率是避免器官。
Objective To explore the characteristics of oxygen delivery, oxygen consumption and oxygen extraction ratio in burn patients with sepsis,and to analyze the relationship between the clinical prognosis and oxygen metabolism.Methods Thirty two burn patients with sepsis admitted to our Burn Institute from March 1993 to September 1998 were analyzed. The Swan Ganz catheter was inserted for monitoring hemodynamics.According to the arterial and venous partial pressure of oxygen, oxygen saturation and hemoglobin,the oxygen delivery, amount of oxygen consumption and oxygen extraction ratio were calculated.Results The increases in oxygen delivery, amount of oxygen consumption and oxygen extraction ratio were observed when the sepsis emerged.They were gradually restored as the conditions of the patients became stable, but still higher than the normal throughout the course of the observation. However, when the patients developed MODS,the amount of oxygen consumption and oxygen extraction ratio were lower than those in the patients without MODS despite an increase in DO 2 , showing a different pattern of dependency of VO 2 to DO 2 , and severe acidosis was manifested. Oxygen delivery, amount of oxygen consumption and oxygen extraction ratio at the terminal stage of MODS subsequent to sepsis were obviously lower than those of the survivors.Conclusion Hypermetabolism is one of the clinical manifestations in patients with sepsis, therefore, to ensure an ample oxygen delivery,reduce amount of oxygen consumption and improve tissue oxygen extraction ratio should be the importance measures to avoid tissue damage.
出处
《创伤外科杂志》
2001年第1期16-18,共3页
Journal of Traumatic Surgery
