急诊心肺复苏患者氧利用率的变化及意义

Studing on Oxygen Utilization Coefficient in Emergency Patients Undergoing Cardiopulmonary Resuscitations

目的:探讨急诊心肺复苏患者氧利用率(O2UC)的变化及意义。方法:①将71例危重病人分为急诊心肺复苏组(A组,26例)、非心肺复苏危重病人组(B组,45例);设正常人对照组(C组,30例)。②A、B组患者于急诊入院抢救时和住院后1,2,3,5,7,10天分别于晨8时抽动、静脉血各一次查血气,并计算O2UC(C组仅做一次)。结果:①急诊入院时和住院第1天,A、B组的O2UC均显著高于C组(P<0.01),而A组亦高于B组(P<0.01)。②住院第3天起,A、B组O2UC均很快下降(与C组比较,P<0.05),且A组较B组下降更明显(P<0.05)。B组于第5天起O2UC逐渐回升至正常;而A组于第3天起,O2UC持续低于C组(P<0.01)。结论:急诊心肺复苏后患者早期O2UC常升高,而中晚期则常明显下降,且病情严重、预后差。O2UC可作为判断急诊心肺复苏病人组织缺氧、病情严重程度和评估预后的有效指标。

Objective: To research significance and alteration of oxygen utilization coefficient (O2UC) in emergency patients undergoing cardiopulmonary resuscitations(CPR). Methods: (1)71 critical stressed patients were subdivided into different groups (Group A, 26 emergency patients undergoing CPR; Group B, 45 critically ill patients without CPR ) and 30 normal subject group (Group C) were selected for comparism. (2)Gas analysis of arterial blood and central venous blood and calculation of O2UC were carried out in group A and group B on admission and 1,2,3,5,7,10 days after admission, and which was carried out only in group C. Result; (3) On admission and 1 day after admission, O2UC in group A and group B were significantly higher than in group C(P< 0.01), and O2UC in group A were obviously higher than that of group B (P< 0.01). (2)From beginning with 3 days after admission, O2UC in group A and groups B were lower than that in group C(P< 0.05), and O2UC in group A were obviously lower than those in group B(P< 0.05). From 5 days after admission, O2UC in group B were then improve and were not significantly different from that in group C (P> 0.05), but O2UC in group A remained at a lower level (compared with group C, P< 0.01). Conclusious: O2UC in emergency patients undergoing CPR was frequently higher in early stage, but were frequently obviously lower in middle and later period, and this predicts more severe disease, wore prognosis.