静脉输氧技术治疗感染性疾病严重低氧血症的探讨

目的　探讨纠正感染性疾病患者严重低氧血症的给氧新方法。方法　将高浓度氧气溶解在常规输液用液体内制备成为高氧液 ,通过静脉输液的方式进行输氧。对 6例严重急性呼吸综合征 (SARS)和 3例艾滋病患者每日静脉滴注高氧液 5 0 0～ 70 0 m l,疗程 1～ 5 d。观察治疗前后患者的临床症状及血氧指标变化。结果　在静脉输注高氧液 2 0 min～ 4 h后 ,9例患者的缺氧症状均缓解 ,呼吸由 2 9～ 4 9次 / min降为 18～2 2次 / m in,心率由 89～ 14 5次 / m in降为 6 0～ 79次 / min,2例昏迷患者意识转清。低氧血症逐渐恢复正常 ,动脉血氧分压 (Pa O2 )由平均 5 6 m m Hg(1mm Hg=0 .133k Pa)变为 87m m Hg;动脉血氧饱和度 (Sa O2 )由平均0 .89变为 0 .96。结论　对 SARS和艾滋病等感染性疾病患者的低氧血症 ,常规气道供氧有时难以奏效 ;静脉输氧能够迅速提高 Pa O2 ,可作为感染性疾病严重低氧血症的综合治疗措施之一 ;尤其是静脉输氧绕过了SARS患者弥散功能障碍的肺泡 ,有助于此类患者的抢救。

Study of infusion of oxygenenriched liquid to correct severe hypoxemia in infectious diseases:a report of pilot clinical study

Objective To investigate a new therapy for effectively correcting severe hypoxemia in patients with infectious diseases by infusion of oxygenenriched liquid,in order to raise the partial pressure of blood oxygen without passing through pathologically damaged alveoli of such patients. Methods Intravenous drip with oxygenenriched liquids was given to 6 cases suffering from severe acute respiratory syndrome (SARS),and 3 cases of acquired immune deficiency syndrome(AIDS) in the course of treatment for 1 to 5 days,500-700 ml per day. Results For all the 9 SARS cases,their hypoxemia was gradually corrected to normal in 20 minutes' or 4 hours' intravenous drip with oxygenenriched liquid. Respiratory rate decreased from 29-49 breath/min to 18-22 breath/min,heart rate decreased from 89-145 beats/min to 60-79 beats/min,two faint patients regained consciousness,hypoxemia was redressed,partial pressure of oxygen in artery increased from 56 mm Hg(1 mm Hg=0.133 kPa) to 87 mm Hg,saturation of oxygen increased from 0.89 to 0.96. Conclusion Intravenous drip of the oxygenenriched liquid effectively helped correct the hypoxemia of SARS and other infectious diseases cases by bypassing the diseased alveoli through which oxygen would not pass into the blood by conventional oxygen inhalation. This therapy of oxygenenriched liquid infusion could be quite lifesaving in the combined treatment for SARS and other infectious diseases.