| 唐伟伟,方长太,白兆青,龙章彪,陈圆圆.脓毒症患者PtcO2PtcCO2的监测意义及对预后的评估作用研究[J].,2019,19(17):3334-3337 |
| 脓毒症患者PtcO2PtcCO2的监测意义及对预后的评估作用研究 |
| A Study on the Significance of Monitoring PtcO2PtcCO2 in Sepsis Patients and the Evaluation of Prognosis |
| 投稿时间：2018-12-28 修订日期：2019-01-23 |
| DOI：10.13241/j.cnki.pmb.2019.17.028 |
| 中文关键词: 脓毒症 无创经皮组织氧分压 二氧化碳分压 预后 |
| 英文关键词: Sepsis Noninvasive percutaneous tissue oxygen partial pressure Partial pressure of carbon dioxide The prognosis |
| 基金项目:安徽医科大学2016-2017校科研项目(2017xkj076) |
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| 中文摘要: |
| 摘要 目的：探讨脓毒症患者无创经皮组织氧分压(tcpO2)和二氧化碳分压(tcpCO2)的监测意义及用于患者预后评估的价值。方法：选择2016年1月至2018年12月我院接诊的80例脓毒症患者进行研究，根据监测方式的不同分为观察组(n=50)和对照组(n=30)。对照组患者采用常规监测动脉血气，观察组患者采用经皮氧分压/二氧化碳分压连续监测，并根据相关数据指导液体复苏，提高氧输送，并追踪患者预后。分析和比较两组的tcpO2、tcpCO2、氧偏移度及急性生理与慢性健康评分Ⅱ(APACHEⅡ)在脓毒症的变化及诊断价值。结果：观察组患者tcpO2、tcpCO2、氧偏移度及APACHEⅡ均明显高于对照组(P＜0.05)；两组死亡组患者tcpO2、氧偏移度及APACHEⅡ均显著高于存活组、而tcpCO2低于存活组(P＜0.05)；logistic回归分析显示tcpO2、tcpCO2均与氧偏移度及APACHEⅡ呈显著正相关(P＜0.05)；tcpO2诊断脓毒症的AUC为0.806，95%CI为0.710~0.902；tcpCO2诊断脓毒症的AUC为0.723，95%CI为0.608~0.839；氧偏移度诊断脓毒症的AUC为0.970，95%CI为0.938~1.000；APACHEⅡ诊断脓毒症的AUC为0.932，95%CI为0.879~0.985；联合检测诊断脓毒症的AUC为0.997，95%CI为0.989~1.000，联合检测的特异度、准确度分别为93.74%、95.68%，显著高于各指标单独检测（P<0.05）。结论：经皮氧/二氧化碳分压监测装置早期监测有助于早期评估脓毒症的严重程度与预后。 |
| 英文摘要: |
| ABSTRACT Objective: To study on the significance of monitoring Noninvasive percutaneous oxygen partial pressure (tcpO2) and carbon dioxide partial pressure (tcpCO2) in sepsis patients and the evaluation of prognosis. Methods: 80 patients with sepsis treated in our hospital from January 2016 to December 2018 were selected for the study, the monitoring methods were divided into observation group (n=50) and control group (n=30). Patients in the control group were routinely monitored for arterial blood gas, while patients in the observation group were continuously monitored for percutaneous oxygen partial pressure/carbon dioxide partial pressure. Fluid resuscitation was guided according to relevant data to improve oxygen delivery, and the prognosis of patients was tracked. Analysis of tcpO2, tcpCO2, oxygen migration degree and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) change in sepsis and diagnostic value. Results: Observation group of patients tcpO2, tcpCO2, oxygen migration degree and APACHE Ⅱ were significantly higher than that of control group (P<0.05); Two groups of patients death tcpO2, oxygen migration and APACHE Ⅱ group were significantly higher than survival, while tcpCO2 is lower than the survival group (P<0.05); Logistic regression analysis showed that tcpO2 and tcpCO2 with oxygen migration and APACHE Ⅱ has significant positive correlation (P<0.05); The AUC of tcpO2 in the diagnosis of sepsis was 0.806, and the 95%ci was 0.710~0.902. The AUC of tcpCO2 in the diagnosis of sepsis was 0.723, and the 95%CI was 0.608~0.839. The AUC and 95%ci in the diagnosis of sepsis were 0.970 and 0.938~1.000 respectively. APACHE Ⅱ diagnosis of sepsis in the AUC is 0.932, 95% CI 0.879 to 0.985; The AUC and 95% of combined detection in the diagnosis of sepsis were 0.997 and 0.989~1.000, respectively. The specificity and accuracy of combined detection were 93.74% and 95.68%, respectively, which were significantly higher than the individual detection of each indicator(P<0.05). Conclusion: Early detection of percutaneous oxygen/carbon dioxide partial pressure monitoring device is helpful for early assessment of sepsis severity and prognosis, which is worthy of popularization and application. |
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