经皮氧监测对急性呼吸窘迫综合征的早期预警及指导治疗

目的观察经皮氧（PtcO2）监测对急性呼吸窘迫综合征（ANDS）的早期预警及指导治疗作用。方法92例急性肺损伤（ALI）患者随机分为经皮氧监测组及非经皮氧监测组（各46例）。2组病人人院后均给予常规治疗，发生ARDS时给予加强治疗。经皮氧监测组以PtcO2／FiO2≤250mmHg考虑发生ARDS，非经皮氧监测组每8h监测Pa02，以PacO2／Fi02≤200mmHg考虑发生ARDS。比较2组病人ARDS的发生率、诊断ARDS的时间、诊断ARDS时PacO2／FiO2、有创机械通气的发生率。结果2组病人的ARDS发生率的差异无统计学意义（P〉0．05）。经皮氧监测组ARDS的诊断时间早于非经皮氧监测组（P〈0．05），诊断ARDS时的PacO2／FiO2高于非经皮氧监测治疗组（P〈0．05），诊断后有创机械通气的发生率低于非经皮氧监测组（P〈0．05）。结论经皮氧监测组能够较早预警ARDS的发生并有效指导治疗，改善预后。

Warning Effect of Transcutaneous O_2 Monitoring in Early Diagnosis and Treatment of Patients with Acute Respiratory Distress Syndrome

Objective To investigate the warning effect of transcutaneous O2 （ PtcO2 ） monitoring in early diagnosis and treatment of patients with acute respiratory distress syndrome （ARDS）. Methods 92 patients with acute lung injury（ALl） were arranged at random in receiving PtcO2 monitoring group and not receiving PtcO2 group（46 patients in each group）. All patients received standard treatment, who were diagnosed as ARDS received treatment. PtcO2/FiO2 ≤250 mmHg was used as warning value to diagnose ARDS in PtcO2 monitoring group. PaO2 was tested every eight hours in non - PtcO2 monitoring group and PaO2/FiO2 ≤00 mmHg was used to diagnose ARDS. The incidence of ARDS,the time point of ARDS, the PaO2/FiO2 value when diagnosed and the incidencc of perlbrming invasive mechanical ventilation were compared. Results There was no significant difference in the incidence of ARDS between the two groups （P 〉 0.05 ）. Compared with non - PtcO2 monitoring group, the time point in PtcO2 monitoring group was earlier （ P 〈 0.05 ）, the PaO2/FiO2 value was higher（ P 〈 0.05 ）, and thc incidence of invasive mechanical ventilation was lower （P 〈 0.05 ）. Conclusion Ptc O2 monitoring helps diagnose early ARDS and direct treatment to improve prognosis.