玉树大地震高原肺水肿患者肺内氧交换效率的观察
详细信息 本馆镜像全文    |  推荐本文 | | 获取馆网全文
摘要
目的观察高原肺水肿(HAPE)患者肺内氧交换效率。方法对22例HAPE患者在治疗前后测定呼吸指数(R I),R I=肺泡-动脉血氧分压差[P(A-a)O2]与动脉血氧分压(PaO2)比值,即P(A-a)O2/PaO2,并与30例当地健康人作对比。结果 HAPE患者治疗前P(A-a)O2、R I(分别为46.22±3.45、1.11±0.14)显著高于治愈后(分别为10.03±1.47、0.14±0.10)和对照组(分别为9.25±1.55、0.13±0.08),(均P<0.01);PaO2[(42.37±4.50)mmHg]显著低于治愈后[(68.88±4.82)mmHg]和对照组[(69.60±5.11)mmHg],(均P<0.01);治愈后与对照组之间比较无统计学意义(均P>0.05)。HAPE患者治疗前R I与P(A-a)O2呈显著正相关(r=0.936,P<0.01)。结论 HAPE患者存在明显的肺内氧交换障碍,R I可作为评价HAPE患者肺内氧交换效率的有效指标之一。
Objective To investigate the efficiency of pulmonary oxygen exchange of in patients with high altitude pulmonary edema(HAPE).Methods The respiratory index(RI),alveolar-arterial oxygen tension difference[P(A-a)O2] and partial pressure of oxygen in arterial blood(PaO2)were measured before and after treatment among 22 cases of paticnts with HAPE,and 30 local healthy volunteers served as controll.Results The P(A-a)O2 and RI(46.22±3.45,1.11±0.14,respectively)were significantly higher in patient group before treatment than after treatment(10.03±1.47,0.14±0.10,respectively)and those in control group(9.25±1.55、0.13±0.08,respectively)(all P<0.01)),while the PaO2[(42.37±4.50)mmHg]was significantly lower in patient group before treatment than after treatment[(68.88±4.82)mmHg] and that in control group[(69.60±5.11)mmHg],(all P<0.01).The RI and P(A-a)O2 were not different between patient group after treatment and the control group(all P>0.05).RI was significantly positive correlated with P(A-a)O2 before treatment in paticnts with HAPE.Conclusion The results showed that efficiency of pulmonary oxygen exchange was significantly diceased in patients with HAPE.RI is helpful for evaluating the efficiency of pulmonary oxygen exchange in patients with HAPE.
引文
[1]Hulgren HN.High altitude pulmonary edema:hemodynamic aspects[J].Int J Sports Med,1997,18(1):20-25.
    [2]胡玲,周苏鹏,赵星.呼吸指数在低氧血症时的临床意义[J].现代诊断与治疗,1997,7(1):15-17.
    [3]杨生岳.急性高原病[J].继续医学教育,2006,20(6):46-51.
    [4]陈有,牟信兵.高原肺水肿发病机制研究进展[J].高原医学杂志,2005,15(2):62-64.
    [5]Roth-Kleiner M,Wagner BP,Bachmann D,et al.Respiratory distresssyndrome innear-term babies after caesarean section[J].Sw MedWkly,2003,133(19-20):283-288.
    [6]汤鸣,梁星群,乔萍.新生儿呼吸衰竭时氧交换指标监测的临床意义[J].中国小儿急救医学,2005,12(4):275-277.
    [7]白雪梅,王莹,李壁如,等.呼吸指数和氧合指数的监测在儿童急性呼吸窘迫综合征中的应用[J].中国小儿急救医学,2006,13(2):126-128.
    [8]杨生岳,冯恩志,祁玉曙,等.呼吸指数判断高原慢性肺心病急性加重期呼吸衰竭程度和预后的意义[J].西北国防医学杂志,2001,22(1):21-23.
    [9]刘志刚,罗苇.呼吸指数和氧合指数动态监测在新生儿呼吸窘迫综合征中的应用[J].实用儿科临床杂志,2008,23(14):1074-1075.

版权所有:© 2023 中国地质图书馆 中国地质调查局地学文献中心