经皮二氧化碳分压与经皮氧分压在NICU监测中的应用

Application of transcutaneous carbon dioxide partial pressure and transcutaneous oxygen partial pressure in NICU monitoring

目的探究经皮二氧化碳分压(TcPCO_(2))与经皮氧分压(TcPO_(2))监测在新生儿重症监护病房(NICU)中的应用价值。方法选取2018年1月至2020年5月我院NICU收治的新生儿60例为研究对象,按照具体病情分为呼吸障碍组(A组)、循环障碍组(B组)、极低出生体重儿组(C组)。监测三组TcPCO_(2)、TcPO_(2)、PaCO_(2)、PaO_(2),并比较TcPCO_(2)与PaCO_(2)、TcPO_(2)与PaO_(2)间的关系。结果A组TcPCO_(2)、PaCO_(2)明显高于B组及C组,TcPO_(2)、PaO_(2)明显低于B组及C组,差异有统计学意义(P<0.05)。三组的TcPCO_(2)与PaCO_(2)均呈正相关(rA=0.765,rB=0.920,rC=0.875,P<0.05);A组TcPO_(2)与PaO_(2)呈中等相关(r=0.601,P<0.05),B组TcPO_(2)与PaO_(2)无相关性(r=-0.006,P>0.05),C组TcPCO_(2)与PaCO_(2)、TcPO_(2)与PaO_(2)均呈较高相关(r=0.875、0.825,P<0.05)。三组TcPCO_(2)、PaCO_(2)差值均接近0(A组、B组、C组测量差值均数分别为0.101、2.991、-0.072),且TcPCO_(2)与PaCO_(2)均有较好的一致性(A组、B组、C组一致性界限内差值绝对值最大值分别为12.000、11.000、8.700)。三组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论TcPCO_(2)测定可准确、连续、无创地评估NICU新生儿,尤其是极低出生体重儿的PaCO_(2),TcPO_(2)能较真实地反映新生儿的氧合情况,值得在NICU广泛应用。

Objective To explore the application value of transcutaneous carbon dioxide partial pressure(TcPCO_(2))and transcutaneous oxygen partial pressure(TcPO_(2))monitoring in the neonatal intensive care unit(NICU).Methods A total of 60 newborns who were admitted to our hospital from January 2018 to May 2020 were selected as the study subjects.According to the specific conditions,they were divided into respiratory disorder group(group A),circulatory disorder group(group B),and very low birth weight infant group(group C).TcPCO_(2),TcPO_(2),PaCO_(2) and PaO_(2) were monitored in the three groups.The correlations between TcPCO_(2) and PaCO_(2),TcPO_(2) and PaO_(2) were compared.Results The TcPCO_(2) and PaCO_(2) test results in group A were significantly higher than those in group B and C.The results of TcPO_(2) and PaO_(2) were significantly lower than those in group B and group C,the differences were statistically significant(P<0.05).The TcPCO_(2) and PaCO_(2) in the three groups were positively correlated(rA=0.765,rB=0.920,rC=0.875,P<0.05).The correlation between TcPO_(2) and PaO_(2) in group A was moderate(r=0.601,P<0.05).There was no correlation between TcPO_(2) and PaO_(2) in group B(r=-0.006,P>0.05).There was a good correlation between TcPCO_(2) and PaCO_(2),TcPO_(2) and PaO_(2) in children in group C(r=0.875,0.825,P<0.05).The differences of TcPCO_(2) and PaCO_(2) in the three groups were close to 0(the mean of the measured differences between the two were 0.101,2.99,and-0.072)and there was a good consistency(the maximum absolute value of the difference within the consistency limit was respectively 12.000,11.000,8.700).There was no statistically significant difference among the three groups in adverse reactions(P>0.05).Conclusion TcPCO_(2) measurement can accurately,continuously and non-invasively assess PaCO_(2) of NICU newborns,especially very low birth weight infants.TcPO_(2) can better reflect the true oxygenation of newborns and is worthy of widespread application in NICU.