应用自编软件分析231例慢性阻塞性肺疾病患者动脉血气图的体会

目的 :应用计算机软件分析慢性阻塞性肺疾病 (COPD)患者动脉血气指标的临床意义。方法 :应用Win98操作平台 ,Borland公司可视化软件开发工具 Delphi5 .0 ,开发动脉血气图计算机辅助判断系统软件 ,并观察 2 31例 COPD患者动脉血气指标在血气图上的变化。结果 :1用计算机软件判断动脉血气指标在动脉血气图上分区所用时间 ,吸氧患者为 (4 .7± 0 .5 ) s,明显低于手工计算判断所需的 (90 .2± 4 .9) s(P<0 .0 0 1)。2急性发作期患者的动脉血气指标分布在通气不足合并换气损害区 (5区 )最多 ,占 5 5 .4 % ,通气代偿换气损害区 (4区 )占 2 2 .9% ,通气过度合并换气损害区 (6区 )占 2 1.6 %。 3随病情的好转 ,血气指标由 5区向 4和 6区移行 ;10 6例抢救存活者入院和出院时血气指标在动脉血气图上分区变化有极其显著性差异 (P<0 .0 0 1)。4病情加重时动脉血气指标向 5区转移 ,病情越重 ,越向血气图的左上方移动 (严重低氧血症合并高碳酸血症 ) ,死亡患者均处于 5区。结论 :计算机软件分析动脉血气图所需时间较手工判断明显缩短 ,并能反映病情变化。

Clinical application of a software for the analysis of arterial blood gases graph in 231 patients with chronic obstructive pulmonary disease

OBJECTIVE: To evaluate the clinical significance of a computer software for the analysis of arterial blood gases graph (ABGG) in chronic obstructive pulmonary disease(COPD). METHODS: The software was developed with Win98 as the operating platform and the visual software Delphi 5.0 from Borland Company, and it was used for evaluation of the changes in arterial blood gases (ABG) of 231 COPD cases. RESULTS: (1) With the software it took only (4.7+/-0.5)s to draw and analyze an ABGG of COPD patients during oxygen inhalation; the time was much shorter than manual analysis (90.2+/-4.9)s, P<0.001. (2) During acute attack, the distributions of the arterial blood gases parameters on ABGG were as follows: 55.4% of cases in the area of insufficient ventilation and deranged gas exchange (area 5), 22.9% of cases in the area of compensated ventilation and deranged gas exchange (area 4), 21.6% of cases in the area of excessive ventilation and deranged gas exchange (area 6). (3) When the COPD patient's condition improved, the location of ABG in ABGG shifted from area 5 to area 4 or area 6. The distributions of the arterial blood gases parameters on ABGG of 106 cases on admission were significantly different from those at the time of discharge. (4) With deterioration of patient's condition, it shifted to area 5. Before death, the arterial blood gases parameters were exclusively in the area 5. CONCLUSION: The computer software for ABGG shortened the time to draw and evaluate ABG during oxygen inhalation, and it could reflect the changes in patient's condition promptly.