新生儿重症肺炎的氧合功能变化

Variation of Oxygenation in Neonates with Serious Pulmonitis

探讨新生儿重症肺炎发生气体交换障碍的机制.采用丹麦雷度公司ABL 620型血气分析仪对40例新生儿重症肺炎、I型呼吸衰竭进行氧合功能指标监测,主要指标为PaO2、P50、Shunt、Px、A aDO2、OI和RI.结果显示,40例新生儿重症肺炎PaO2、P50、Px和OI均下降,而Shunt、A aDO2和RI则明显增高.各项指标较正常对照组有显著差异(P<0.01).21例经呼吸机治疗后,各项指标有明显改善(P<0.01).因此,重症肺炎、I型呼衰气体交换障碍主要表现为低氧血症.表明监测氧合功能指标对观察病情变化、转归及治疗有指导意义.

In order to discuss the mechanism of gas exchange impairment in neonates with serious pulmonitis, oxygenation parameters (PaO2, P50, Shunt, Px, AaO2, OI and RI) of 40 children patients (28 males and 12 females) with serious pulmonitis or Itype respiratory failure were measured with ABL620 blood gas analyzer. 40 normal children (25 males and 15 females) were also selected for comparison. Results showed that PaO2, P50, Px and OI of the 40 cases of serious pulmonitis decreased, whereas their Shunt, AaO2 and RI increased markedly. All parameters were clearly different from those of the normal children (P<0.01). After being treated by the respiratory machine, parameters of 21 cases have markedly improved, compared with those before the treatment (P<0.01). Therefore, it is suggested that gas exchange impairment in serious pulmonitis and Itype respiratory failure are represented by hypoxemia. The decrease in PO2?P50 and the increase in RI indicate impairment of pulmonary oxygenation. Measuring PAaO2 at FiO2 =30%～60% shows decrease with Shunt, but inversely with PaO2. This result indicates the lowered capacity of taking oxygen of pulmonary alveolus. This study indicates that measuring the oxygenation parameters is beneficial in observing the variation, transfer and treatment of pathogenesis.