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| 氧合指数对急性呼吸窘迫综合征肺内分流的判定价值 | |
| 引用本文： | 胡伟航,刘长文,胡炜,陆骏,郑永科,朱克毅,朱英,王剑荣. 氧合指数对急性呼吸窘迫综合征肺内分流的判定价值[J]. 医学研究杂志, 2011, 40(10): 72-75 |
| 作者姓名： | 胡伟航 刘长文 胡炜 陆骏 郑永科 朱克毅 朱英 王剑荣 |
| 作者单位： | 310006,杭州市第一人民医院危重病医学科 |
| 基金项目： | 杭州市医药卫生科技计划 |
| 摘 要： | 目的研究氧合指数(PaO2/FiO2)用于反映急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的肺内分流(Qsp/Qt)准确度下降程度。方法符合ARDS诊断标准患者12例,气管插管呼吸机支持,采用肺保护性通气策略(Vt6ml/kg),留置Swan-Ganz导管,采用低流速法测定准静态肺压力-容积曲线。逐步调整PEEP水平,观察血流动力学、呼吸力学的变化,分别留取外周及肺动脉血行血气分析,分别计算Qsp/Qt和PaO2/FiO2,对结果进行回归分析。结果①Qsp/Qt和PaO2/FiO2两者之间存在线性相关,但决定系数r2只有0.432,相关性偏小;②Qsp/Qt(%)的多元回归方程:y=56.542-3.371x1-0.056x2+0.594x3+2.84x4,x1为PaO2/FiO2,x2为Hgb,x3为PAWP,x4为CI,校正r2=0.538,(P<0.01)。结论用PaO2/FiO2测算ARDS的Qsp/Qt精确度下降,决定系数r2只有0.432,Qsp/Qt除外PaO2/FiO2还受Hgb、肺动脉楔压(plumonary artery wedge pres-sure,PAWP)及心脏指数(cardiac index,CI)等影响。 |
| 关 键 词： | 急性呼吸窘迫综合征 肺内分流 氧合指数 |
| 收稿时间： | 2011-02-08 |
| 修稿时间： | 2011-02-28 |
Value of PaO2/FiO2 in Reflecting the Intrapulmonary Shunting of Acute Respiratory Distress Syndrome |
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| HuWeihang,Liu Changwen,Hu Wei,Lu Jun,Zheng Yongke,Zhu Keyi,Zhu Ying,Wang Jianyong. Value of PaO2/FiO2 in Reflecting the Intrapulmonary Shunting of Acute Respiratory Distress Syndrome[J]. Journal of Medical Research, 2011, 40(10): 72-75 | |
| Authors: | HuWeihang Liu Changwen Hu Wei Lu Jun Zheng Yongke Zhu Keyi Zhu Ying Wang Jianyong |
| Affiliation: | Hu Weihang,Liu Changwen,Hu Wei,Lu Jun,Zheng Yongke,Zhu Keyi,Zhu Ying,Wang Jianyong.Hangzhou First People′s Hospital,Zhejiang Province,Zhejiang 310006,China |
| Abstract: | Objective To study how did the accuracy of the oxygenation index(PaO2/FiO2) reflecting the intrapulmonary shunting(Qsp/Qt) of acute respiratory distress syndrome reduce.Methods Twelve patients who had ARDS were recruited to the study.All required mechanical ventilation,which used lung ventilation protective strategy(Vt6ml/kg),and had a Swan-Ganz catheter.Then,P-V curves were determined by low-flow method.Subsequently,the parameters of respiratory mechanics and haemodynamics and the blood gas analysis result... |
| Keywords: | Acute respiratory distress syndrome Intrapulmonary shunting Oxygenation index |
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