动脉二氧化碳分压的极值波动对早产儿严重脑室内出血的影响

发布时间：2018-03-06 06:14

本文选题：二氧化碳分压　切入点：脑室内出血　出处：《南京医科大学学报(自然科学版)》2017年08期 　论文类型：期刊论文

【摘要】：目的:对早产儿动脉二氧化碳分压(PaCO_2)极值及差值与严重脑室内出血的关系进行探究,以期寻求早产儿PaCO_2的安全范围。方法:收集2010年1月—2013年1月在南京医科大学附属儿童医院NICU住院的152例早产儿资料,判断PaCO_2与颅内出血的关系。结果:(1)152例早产儿中,严重脑室内出血组54例,无严重脑室内出血组98例。(2)严重脑室内出血患儿较非严重脑室内出血者,PaCO_2峰值更大(65.00 mm Hg vs.52.00 mm Hg)、差值更大(35.60 mm Hg vs.16.35 mm Hg),而PaCO_2谷值更小(30.30 mm Hg vs.36.00 mm Hg),P均0.05。(3)与没有使用通气支持的患儿相比,应用机械通气(MV)或持续正压气道通气(CPAP)模式的患儿PaCO_2的波动范围更大。(4)ROC分析示PaCO_2在31.60~62.00 mm Hg范围内的患儿(n=85,55.92%),严重脑室内出血发生率仅为15.29%。(5)Logistic回归分析显示:影响早产儿严重脑室内出血的独立危险因素为PaCO_2峰值62.20 mm Hg、PaCO_2谷值31.60mm Hg及PaCO_2差值26.15 mm Hg(OR值分别为3.25、2.15和3.31,P均0.05)。结论:早产儿由于自身脑发育及脑血流调节的特点,动态监测PaCO_2、界定PaCO_2的"安全"范围显得尤为重要。
[Abstract]:Objective: to explore the relationship between the extreme value of arterial carbon dioxide partial pressure (Paco _ 2) and the difference value and severe intracerebroventricular hemorrhage in premature infants. Methods: from January 2010 to January 2013, the data of 152 premature infants hospitalized in NICU affiliated Children's Hospital of Nanjing Medical University were collected to determine the relationship between PaCO_2 and intracranial hemorrhage. Severe intraventricular hemorrhage group (54 cases), 98 cases without severe intraventricular hemorrhage (n = 98) severe intracerebroventricular hemorrhage children with severe intraventricular hemorrhage had a greater peak value of PaCO2 (65.00 mm Hg vs.52.00 mm HgG), greater difference of 35.60 mm Hg vs.16.35 mm HgN, and smaller PaCO_2 valley of 30.30 mm Hg vs.36.00 mm Hgg P 0.05.3). Compared with children with ventilation support, The range of fluctuation of PaCO_2 in children with mechanical ventilation (MV) or continuous positive airway pressure ventilation (CPAP) was larger. The results of ROC analysis showed that the incidence of severe intracerebroventricular hemorrhage was 15.29%. 5 logistic regression analysis showed that the incidence of severe intraventricular hemorrhage was 15.29%. 5% logistic regression analysis showed that the range of PaCO_2 in the range of 31.60 ~ 62.00 mm Hg was 55.92 mm Hg, and the incidence of severe intracerebroventricular hemorrhage was only 15.29%. 5 logistic regression analysis showed that the incidence of severe intraventricular hemorrhage was 15.29%. The independent risk factors of severe intracerebroventricular hemorrhage in infants were the peak value of PaCO_2 (62.20mm) and the valley value of Paco _ 2 (31.60mm Hg) and the difference of PaCO_2 (26.15mm) Hg(OR of 3.250.15mm and 3.31mm Hg(OR, respectively. Conclusion: preterm infants have the characteristics of cerebral development and cerebral blood flow regulation due to their own brain development. Dynamic monitoring of Paco _ 2 is particularly important to define the "safe" scope of PaCO_2.
【作者单位】：南京医科大学附属儿童医院新生儿医疗中心;
【基金】：南京市医学科技发展项目(YKK12108)
【分类号】：R743.34

【参考文献】