动静脉血气分析的临床价值研究

发布时间：2019-01-03 10:47

【摘要】：目的：分别比较静脉血清与动脉全血电解质、静脉血清与静脉全血电解质、动脉全血与静脉全血血气分析检测结果之间的差异，分析其内在关联，并探讨相关临床应用价值。方法：前瞻性随机对照研究，选取2013年1月20日至2014年1月25日期间于我院行择期手术患者60例。于围麻醉期间某一时间点同时采集外周动脉和中心静脉血标本。通过血气分析仪分别对动脉全血、静脉全血和静脉血清标本进行检测。比较动脉全血与静脉血清、静脉血清与静脉全血电解质检测结果的差异。通过散点图分析两种样本检测结果之间是否存在相关关系，并计算两者之间的相关度。最后纳入线性回归分析进一步建立回归方程。比较动脉全血与静脉全血氧合、酸碱、电解质、血糖等指标存在的差异，分析其临床意义。结果：动脉全血和静脉血清Na+、K+、Ca2+检测结果均存在统计学差异（P=0.000），其中动脉全血与静脉血清Na+、K+检测结果分别成正相关，相关度r分别为0.852，0.880。线性回归方程分别为静脉血清Na（+mmol/L）=0.814×动脉全血Na++24.282，静脉血清K+（mmol/L）=0.863×动脉全血K++0.773。静脉血清和静脉全血Na+、K+、Ca2+检测结果均存在统计学差异（P=0.000），，其中静脉血清与静脉全血Na+、K+的检测结果分别成正相关，相关度r分别为0.796，0.902。线性回归方程分别为静脉血清Na+（mmol/L）=0.645×静脉全血Na++47.598，静脉血清K+（mmol/L）=0.926×静脉全血K++0.613。动脉全血与静脉全血pH差值（AVpH）约为0.0（595%置信区间为0.04~0.06）；静脉全血与动脉全血PCO2差值（VAPCO2）约为7.4mmHg（95%置信区间为6.4~8.4mmHg）。动脉全血与静脉全血BE、Hb、Hct相比无明显差异；电解质检测结果差异无明显临床意义；静脉全血血糖明显低于动脉全血检测结果（P=0.000）。结论：动脉全血与静脉血清Na+、K+、Ca2+的结果具有显著性差异，通过回归方程，可由动脉全血Na+、K+结果推算出静脉血清中相应离子浓度。静脉血清和静脉全血Na+、K+、Ca2+的结果具有显著性差异，通过回归方程，可由静脉全血Na+、K+结果推算出静脉血清中相应离子浓度。一般情况下，动脉全血和静脉全血pH差值和PCO2差值波动在一定范围，BE、Hb、Hct及电解质等指标无明显差别，血糖值则呈现显著差别。
[Abstract]:Objective: to compare the results of blood gas analysis between venous blood and arterial blood electrolyte, venous blood electrolyte and venous blood electrolyte, and to analyze the relationship between them. And explore the value of clinical application. Methods: from January 20, 2013 to January 25, 2014, 60 patients underwent elective operation in our hospital. Blood samples of peripheral artery and central vein were collected at a certain time point during perianaesthesia. Arterial whole blood, venous whole blood and venous blood samples were detected by blood gas analyzer. To compare the results of electrolyte detection between arterial blood and venous blood, venous blood and venous whole blood. The correlation between the two samples is analyzed by scatter plot, and the correlation between them is calculated. Finally, the regression equation is established with linear regression analysis. To compare the difference of arterial whole blood oxygenation, acid-base, electrolyte, blood sugar and so on, and to analyze its clinical significance. Results: there was significant difference in Na, K, Ca2 between arterial blood and venous blood (P0. 000). The Na, K of whole arterial blood and venous blood were positively correlated, the correlation r was 0. 852n0.880 respectively. The linear regression equations were as follows: Na (mmol/L) = 0.814 脳 Na 24.282, K (mmol/L) = 0.863 脳 arterial whole blood K 0.773.The linear regression equation was as follows: venous serum Na (mmol/L) = 0.814 脳 arterial whole blood Na 24.282, venous serum K (mmol/L) = 0.863 脳 arterial whole blood K 0.773. There was significant difference in Na, K, Ca2 between venous serum and venous whole blood (P < 0. 000). There was a positive correlation between venous serum and venous whole blood Na, K (r = 0. 796 ~ 0. 902). The linear regression equations were: Na (mmol/L) = 0.645 脳 Na 47.598, K (mmol/L) = 0.926 脳 whole venous blood K 0.6138.The linear regression equations were as follows: venous serum Na (mmol/L) = 0.645 脳 venous whole blood Na 47.598, venous serum K (mmol/L) = 0.926 脳 venous whole blood K 0.613. The difference of pH between arterial and venous blood was about 0.0 (595% CI = 0.04 卤0.06), and that of venous whole blood and arterial whole blood (VAPCO2) was about 7.4mmHg (95% CI = 6.4~8.4mmHg). There was no significant difference between arterial whole blood and venous whole blood BE,Hb,Hct, there was no significant difference in electrolyte test results, and venous whole blood glucose level was significantly lower than that of arterial whole blood test (P0. 000). Conclusion: the results of Na, K, Ca2 in arterial whole blood and venous blood have significant difference. The corresponding ion concentration in venous serum can be calculated from the results of arterial whole blood Na, K by regression equation. There was significant difference between venous serum Na, K, Ca2 and venous whole blood Na, K, Ca2. The corresponding ion concentration in venous serum could be calculated from the results of venous whole blood Na, K by regression equation. In general, the difference of pH and PCO2 in whole blood of artery and vein fluctuated in a certain range, but there was no significant difference in BE,Hb,Hct and electrolyte, but there was significant difference in blood glucose.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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