危重患者心脏手术后氧代谢监测的价值

目的 探讨心脏直视术后危重患氧供需平衡的重要性和临床价值。指导救治，三疗效及预后，预防多器功能衰竭（ＭＯＦ）的发生，使ＩＣＵ监测水平跨跃到细胞水平。方法 对１４８例，心脏直视术后危重入ＩＣＵ后，分阶段动态监测动脉，混合静脉血气，心输出量，胃粘膜ＰＨ值，对代谢这各项监测值之间相关关系进行分析。结果 动静脉血气及其差值的变化与循环，呼吸功能变化呈正在关系；ＡＰＡＣＨＥⅡ评分高，ＳｖＯ２低的极重患

Values of oxygen metabolism in treatment of critical patients after open heart surgery

AIM To investigate the clinical values of oxygen supplydemand balance in critical patients after open heart surgery, to guide the treatment, to evaluate the therapeutic effectiveness and prognosis, and to prevent the occurrence of multiple organ failure (MOF). METHODS On admission to ICU, the arterial, and mixed venous blood gas, cardiac output and pH of gastric mucosa were observed in 148 patientsafter open heart surgery. The indexes of oxygen metabolic dynamics were noted and their interrelationships were analyzed. RESULTS Changes of arteriovenous blood gas differences were positively correlated with those of circulatory and respiratory functions; AVpH and AV PCO 2 were significantly correlated with VO 2 dependent DO 2. CONCLUSION Dynamic observation of oxygen supplydemand and analysis of interrelationship of DO 2 and VO 2 could reflect the practical systemic oxygenation; Oxygen metabolism monitoring was critical to the maintenance of systemic balance of oxygen supply and demand; The maintenance of oxygen supplydemand balance in regional tissues and organs was the key point for preventing the occurrence of MOF.