CAJ | 학술논문

目的探讨脉搏血氧指数(SpO2/FiO2)监测在上消化道出血合并不同程度休克的临床意义.方法上消化道出血合并不同程度体克患者共82例,包括轻度休克组24例,中度休克组36例,重度休克组22例,观察下列指标:①记录各组低氧血症的发生率.②在治疗的第1个4h每隔30分钟共8个时点同步测定脉搏血氧指数和氧合指数(PaO2/FiO2)并作Spearman等级相关回归分析.结果低氧血症发生率在轻度休克组为4.17％(1例),中度休克组为33.3％(12例),重度休克组为90.9％(20例),组间比较差异有统计学意义(x2=37.19,P＜ 0.01).轻度休克组两变量呈正相关(Y=45.2+0.9032X,γ=0.9943,P=0.0322),脉搏血氧指数316相当于氧合指数300.中度休克组两变量也呈正相关(Y=49.7+0.9177X,γ=0.9874,P=0.0371),脉搏血氧指数325相当于氧合指数300.重度休克组两变量相关关系无显著性(F检验,F =0.3306,P=0.1019).结论轻度和中度休克患者脉搏血氧指数可替代氧合指数监测,重度休克患者脉搏血氧指数偏差较大,需动态监测氧合指数.
목적 탐토맥박혈양지수(SpO2/FiO2)감측재상소화도출혈합병불동정도휴극적림상의의.방법 상소화도출혈합병불동정도체극환자공82례,포괄경도휴극조24례,중도휴극조36례,중도휴극조22례,관찰하렬지표:①기록각조저양혈증적발생솔.②재치료적제1개4h매격30분종공8개시점동보측정맥박혈양지수화양합지수(PaO2/FiO2)병작Spearman등급상관회귀분석.결과 저양혈증발생솔재경도휴극조위4.17％(1례),중도휴극조위33.3％(12례),중도휴극조위90.9％(20례),조간비교차이유통계학의의(x2=37.19,P＜ 0.01).경도휴극조량변량정정상관(Y=45.2+0.9032X,γ=0.9943,P=0.0322),맥박혈양지수316상당우양합지수300.중도휴극조량변량야정정상관(Y=49.7+0.9177X,γ=0.9874,P=0.0371),맥박혈양지수325상당우양합지수300.중도휴극조량변량상관관계무현저성(F검험,F =0.3306,P=0.1019).결론 경도화중도휴극환자맥박혈양지수가체대양합지수감측,중도휴극환자맥박혈양지수편차교대,수동태감측양합지수.
Objective To discuss the clinical significance of monitoring of pulse blood oxygen saturation index (SpO2/FiO2) in upper gastrointestinal bleeding complicated with different degrees of shock.Methods Eight-two patients with upper gastrointestinal bleeding complicated with different degrees of shock,including mild shock group(24 cases),moderate shock group(36 cases)and severe shock group(22 cases).The following markers were investigated:①The incidence of hypoxemia in each group was recorded.②Pulse blood oxygen saturation index and oxygenation index (PaO2/FiO2) was synchronous measured every 30 minutes at totally 8 time point in the treatment of the first 4 hours,and Spearman rank correlation regression analysis were did.Results Hypoxemia incidence in mild shock group was 4.17％ (1 case),in moderate shock group was 133.3％ (2 cases),in severe shock group was 90.9％ (20 cases),and there were significant differences between the groups(x2 =37.19,P ＜0.01).Two variables were positive related in mild shock group (Y =45.2 + 0.9032X,γ=0.9943,P =0.0322),pulse blood oxygen saturation index 316 was equal to 300 of oxygenation index.Two variables were positive related in moderate shock group also (Y =49.7 + 0.9177X,γ=0.9874,P =0.0371),pulse blood oxygen saturation index 325 was equal to 300 of oxygenation index.Two variables were no related in severe shock group (F test,F =0.3306,P =0.1019).Conclusions Monitoring of pulse blood oxygen saturation index can be replaced by oxygenation index in patients with mild or moderate shock.Relatively large errors occur in pulse blood oxygen saturation index in patients with severe shock,and it needs dynamic monitoring of oxygenation index.