摘要
目的探讨脉搏血氧饱和度(SpO2)/吸入氧浓度(FiO2,简称S/F)的动态监测在重度急性呼吸窘迫综合征(ARDS)患者俯卧位通气(PPV)中的应用。方法纳入行PPV治疗的重度ARDS患者49例,根据去甲肾上腺素(NE)的使用剂量将其分为低剂量组(〈0.2μg·kg-1·min-1)23例和高剂量组(≥0.2μg·kg-1·min-1)26例,回顾性分析两组患者俯卧位前、后S/F与动脉血氧分压(PaO2)/FiO2(P/F)的动态变化,并进行相关性分析。结果与俯卧位前比较,所有患者、低剂量组及高剂量组患者的P/F和S/F均升高,差异均有统计学意义(P〈0.01)。所有患者、低剂量组及高级组患者俯卧位前、后及整体的P/F与S/F均呈正相关(r=0.684,0.651,0.671,0.676,0.619,0.65l,0.691,0.653,0.676,P均〈0.01)。所有患者、低剂量组及高剂量组患者PPV治疗过程中P/F和S/F的变化趋势均为先上升后下降。结论重度ARDS患者行PPV治疗时,S/F可以部分替代P/F进行氧合水平的动态监测,NE的使用和PPV治疗均不影响S/F和P/F的相关性。
Objective To explore application of dynamic monitoring of pulse oxygen saturation ( SpO2 )/fraction of inhaled oxygen ( FiO2, S/F ) in prone position ventilation ( PPV ) in patients with severe acute respiratory distress syndrome(ARDS). Methods Forty-nine patients with severe ARDS and the application of PPV were divided into low dose group(23 cases, 〈0.2 μg · kg-1 · min-1) and high dose group (26 cases, ≥0. 2 μg · kg - 1· min - 1 ) according to the dose of norepinephrine (NE). The dynamic changes of S/F and pressure of oxygen( PaO2 )/ FiO/(P/F) were analyzed retrospectively, then correlation analysis was performed. Results Compare with before prone position, P/F and S/F in all patients, patients of low dose group and high dose group increased significantly after prone position(P 〈0.01 ). P/F were all positively correlated with S/F before and after prone position and of overall in all patients, patients of low dose group and high dose group(r =0. 684,0. 651,0. 671,0. 676,0. 619,0. 651,0. 691,0. 653,0. 676,P 〈0.01 ). In PPV treatment, the change trends of P/F and S/F in all patients, patients of low dose group and high dose group were consistent,which rose at fist and then decreased. Conclusion S/F can partially replace P/F as a dynamic monitoring index of oxygenation level in severe ARDS patients during PPV treatment. Use of NE and PPV treatment have no effect on the correlation of S/F and P/F.
出处
《临床内科杂志》
CAS
2017年第11期758-760,共3页
Journal of Clinical Internal Medicine
关键词
急性呼吸窘迫综合征
俯卧位通气
脉搏血氧饱和度
动脉血氧分压
Acute respiratory distress syndrome
Prone position ventilation
Pulse oxygen saturation
Arterial partial pressure of oxygen