探讨危重病患者的周围动脉和中心静脉血气比较及其评价.docVIP

精品论文 参考文献 探讨危重病患者的周围动脉和中心静脉血气比较及其评价 鹤岗市妇幼保健院 154101 摘要： 目的 研究分析危重病患者动脉和中心静脉血气酸碱平衡状态及其意义。方法 此次研究的对象是选择54例危重病患者，将其临床资料进行回顾性分析，并根据纽约心脏病学会心功能分级将患者分为三组，同时经中心静脉和桡动脉抽血样标本，进行血气分析，比较中心静脉和桡动脉血标本的检测结果。结果 正常心功能和轻度心力衰竭患者，动静脉血气酸碱平衡状态差异无统计学意义（Pgt;0.05）。重度心力衰竭和循环衰竭患者，动静脉血气酸碱平衡状态出现明显分离现象。动脉血示低碳酸血症，而静脉血则反之，二者差异有统计学意义（Plt;0.05）。结论 重度心力衰竭和周围循环衰竭患者，单纯检测动脉血气，并不能反映组织内确切的酸碱状态，周围动脉血和中心静脉血必须同时进行检测。在严重低心排出量和低灌流患者，检测中心静脉血能较好地反映组织酸碱状态。 　　关键词： 心力衰竭；血气分析；酸碱平衡状态 　　 [Abstract] Objective To study the acid-base balance of arterial and central venous blood gas in critically ill patients and its significance. Method the study object is the choice of 54 cases of critically ill patients，the clinical data were retrospective analysis，and according to the New York Heart Association heart function classification，the patients were divided into three groups，and the central venous and radial artery pumping blood samples，blood gas analysis，central venous and radial artery blood samples of test results. Results there was no significant difference in the acid-base balance between arterial blood gas and blood gas in normal cardiac function and mild heart failure（Pgt;0.05）. In patients with severe heart failure and circulatory failure，there was a clear separation between arterial and venous blood gas and acid-base balance. Arterial blood shows low serum carbonic acid，and venous blood on the other hand，the difference between the two is statistically significant（Plt;0.05）. Conclusion in patients with severe heart failure and peripheral circulatory failure，the detection of arterial blood gas alone does not reflect the specific acid-base status，peripheral arterial blood and central venous blood must be detected simultaneously. In the patients with severe low cardiac output and low perfusion，the detection of central venous blood can better reflect the tissue acid-base status. [Key words] heart failure；blood gas analysis；acid base equilibrium state 血气分析是指对各种气体、液体中不同类型的气体和酸碱性物质进行分析的技术过程。目前，血气分析多采用周围动脉（简称动脉