指氧饱和度相关弥散指数在ARDS患者护理评估中的应用

Application of oxygen saturation-related dispersion index in nursing assessment of patients with acute respiratory distress syndrome

目的 探讨指氧饱和度相关弥散指数是否可以作为护士对急性呼吸窘迫综合征（ARDS）患者氧合功能及病情监测的无创指标.方法 回顾2015年4月—2016年4月北京协和医院EICU收治的23例机械通气合并ARDS患者,记录PaO2、SpO2、PEEP、FiO2数值,分别计算氧合指数和指氧饱和度相关弥散指数,各计312例次.结果 氧合指数死亡组低于存活组,指氧饱和度相关弥散指数死亡组低于存活组,差异均有统计学意义（P〈0.05）;指氧饱和度相关弥散指数轻度组、中度组、重度组比较差异有统计学意义（P〈0.05）.组间两两比较发现,重度组分别与轻度组、中度组比较差异均有统计学意义（P〈0.05）.结论 指氧饱和度相关弥散指数可判断ARDS患者预后情况和病情严重程度,尤其对于判别重度ARDS患者有较好的指示作用.作为无创且连续的指标,为ARDS机械通气患者护理评估提供了新的方法.

Objective To explore whether oxygen saturation-related dispersion index can be used as a non-invasive index for nurses to monitor ARDS patients＇ oxygenation and conditions.Methods Totally 23 patients with mechanical ventilation-associated complication and ARDS admitted in Peking Union Medical College Hospital between April 2015 and April 2016 were reviewed. Their PaO2, SpO2, PEEP and FiO2 values were recorded, and oxygenation index （OI） and oxygen saturation-related dispersion index were calculated for 132 case-times, respectively.Results The patients in the death group showed lower OI and oxygen saturation-related dispersion index than the patients in the survival group （P〈0.05）. The difference in oxygen saturation-related dispersion index between the light, middle and heavy groups were statistically significant （P〈0.05）.Conclusions Oxygen saturation-related dispersion index can be used to determine the prognosis of ARDS patients and the severity of the disease, especially the conditions of severe ARDS patients. As a non-invasive and continuous indicator, it provides a new measure for the nursing assessment of patients with mechanical ventilation-associated complication and ARDS.