脉搏血氧指数监测在上消化道出血合并不同程度休克的临床意义
Clinical significance of monitoring of pulse blood oxygen saturation index in upper gastrointestinal bleeding complicated with different degrees of shock
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.
更多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.
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