血气分析在大面积脑梗死老年患者临床治疗及预后中的应用价值

发布时间：2018-06-20 01:19

本文选题：大面积脑梗死 + 老年　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的：比较大面积脑梗死老年患者并发呼吸衰竭时机械通气前后血气变化，，探讨血气变化的机制，揭示血气分析对老年患者大面积脑梗死临床转归的价值，以期为大面积脑梗死出现酸碱平衡紊乱提供最佳的临床治疗依据。方法：采用回顾性分析，以2010年—2013年入住福建医科大学附属协和医院的40例大面积脑梗死老年患者为研究对象，入选病例均进行心电、血压、脉搏、末梢血氧饱和度监测，采集动脉血行血气分析，记录气管插管呼吸机辅助通气前后的动脉血气分析及血氧饱和度监测变化转归，采用GOS评分表对患者的预后进行评定，探讨血气分析变化与呼吸机辅助通气与病情转归的关系。数据采用SPSS18.0统计软件进行处理。结果：根据GOS预后评分表，低氧血症组（Pa0260mmHg）与动脉血氧分压正常组相比差别有统计学意义（p＜0.05），提示低氧血症影响大面积脑梗死患者的预后；血气酸碱值正常组与酸碱值失衡组相比，预后差别有统计学意义(p0.05)，提示酸碱失衡影响患者预后；缺氧24小时内与24小时后行气管插管相比较，差异有统计学意义(P0.05)，提示气管插管早晚与患者预后相关；气管插管机械辅助通气前后，动脉血气指标相比较差异具有统计学意义（p 0.05），气管插管机械辅助械通气明显改善大面积脑梗死患者各项血气指标。结论：低氧血症、血气酸碱值与大面积脑梗死老年患者预后关系密切；早期监测血气分析、进行气管插管辅助机械通气可改善患者血气指标从而改善患者预后。血气分析在大面积脑梗死老年患者临床治疗及预后中的具有重要的应用价值。
[Abstract]:Objective: to compare the changes of blood gas before and after mechanical ventilation in elderly patients with large area cerebral infarction complicated with respiratory failure, to explore the mechanism of blood gas change, and to reveal the value of blood gas analysis in the clinical outcome of large area cerebral infarction in elderly patients. In order to provide the best clinical treatment basis for the occurrence of acid-base balance disorder in large area cerebral infarction. Methods: a retrospective analysis was conducted on 40 elderly patients with large area cerebral infarction who were admitted to Xianghe Hospital of Fujian Medical University from 2010 to 2013. ECG, blood pressure, pulse and oxygen saturation of peripheral blood were monitored. Arterial blood was collected for blood gas analysis, arterial blood gas analysis and blood oxygen saturation monitoring were recorded before and after tracheal intubation ventilator assisted ventilation. The prognosis of the patients was evaluated by GOS score table. To explore the relationship between blood gas analysis and ventilator-assisted ventilation. The data were processed by SPSS 18.0 software. Results: according to the GOS prognosis scale, there was a significant difference between hypoxemia group and normal group (P < 0.05), suggesting that hypoxemia affects the prognosis of patients with large cerebral infarction. The difference of prognosis between the normal blood gas pH group and the pH imbalance group was statistically significant (p 0.05), which indicated that the acid-base imbalance affected the prognosis of the patients, and the tracheal intubation was performed within 24 hours of hypoxia and 24 hours after hypoxia. The difference was statistically significant (P 0.05), indicating that tracheal intubation was related to the prognosis of the patients in the morning and evening, and before and after mechanical ventilation with tracheal intubation, The difference of arterial blood gas index was statistically significant (p 0.05). Mechanical ventilation with tracheal intubation could improve the blood gas index in patients with large area cerebral infarction. Conclusion: hypoxemia, blood gas pH and prognosis of elderly patients with large area cerebral infarction are closely related to the prognosis, early monitoring of blood gas analysis and tracheal intubation assisted mechanical ventilation can improve the blood gas index and improve the prognosis of patients. Blood gas analysis plays an important role in the treatment and prognosis of elderly patients with large area cerebral infarction.
【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】：R743.3

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