【摘要】：目的： 分別比較靜脈血清與動脈全血電解質(zhì)、靜脈血清與靜脈全血電解質(zhì)、動脈全血與靜脈全血血氣分析檢測結(jié)果之間的差異，分析其內(nèi)在關(guān)聯(lián)，并探討相關(guān)臨床應(yīng)用價值。 方法： 前瞻性隨機對照研究，選取2013年1月20日至2014年1月25日期間于我院行擇期手術(shù)患者60例。于圍麻醉期間某一時間點同時采集外周動脈和中心靜脈血標本。通過血氣分析儀分別對動脈全血、靜脈全血和靜脈血清標本進行檢測。比較動脈全血與靜脈血清、靜脈血清與靜脈全血電解質(zhì)檢測結(jié)果的差異。通過散點圖分析兩種樣本檢測結(jié)果之間是否存在相關(guān)關(guān)系，并計算兩者之間的相關(guān)度。最后納入線性回歸分析進一步建立回歸方程。比較動脈全血與靜脈全血氧合、酸堿、電解質(zhì)、血糖等指標存在的差異，分析其臨床意義。 結(jié)果： 動脈全血和靜脈血清Na+、K+、Ca2+檢測結(jié)果均存在統(tǒng)計學(xué)差異（P=0.000），其中動脈全血與靜脈血清Na+、K+檢測結(jié)果分別成正相關(guān)，相關(guān)度r分別為0.852，0.880。線性回歸方程分別為靜脈血清Na（+mmol/L）=0.814×動脈全血Na++24.282，靜脈血清K+（mmol/L）=0.863×動脈全血K++0.773。 靜脈血清和靜脈全血Na+、K+、Ca2+檢測結(jié)果均存在統(tǒng)計學(xué)差異（P=0.000），，其中靜脈血清與靜脈全血Na+、K+的檢測結(jié)果分別成正相關(guān)，相關(guān)度r分別為0.796，0.902。線性回歸方程分別為靜脈血清Na+（mmol/L）=0.645×靜脈全血Na++47.598，靜脈血清K+（mmol/L）=0.926×靜脈全血K++0.613。 動脈全血與靜脈全血pH差值（AVpH）約為0.0（595%置信區(qū)間為0.04~0.06）；靜脈全血與動脈全血PCO2差值（VAPCO2）約為7.4mmHg（95%置信區(qū)間為6.4~8.4mmHg）。動脈全血與靜脈全血BE、Hb、Hct相比無明顯差異；電解質(zhì)檢測結(jié)果差異無明顯臨床意義；靜脈全血血糖明顯低于動脈全血檢測結(jié)果（P=0.000）。 結(jié)論： 動脈全血與靜脈血清Na+、K+、Ca2+的結(jié)果具有顯著性差異，通過回歸方程，可由動脈全血Na+、K+結(jié)果推算出靜脈血清中相應(yīng)離子濃度。靜脈血清和靜脈全血Na+、K+、Ca2+的結(jié)果具有顯著性差異，通過回歸方程，可由靜脈全血Na+、K+結(jié)果推算出靜脈血清中相應(yīng)離子濃度。一般情況下，動脈全血和靜脈全血pH差值和PCO2差值波動在一定范圍，BE、Hb、Hct及電解質(zhì)等指標無明顯差別，血糖值則呈現(xiàn)顯著差別。
[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 鹵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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R614

【參考文獻】

相關(guān)期刊論文 前7條

1 於華敏;傅紅霞;;動靜脈血氣分析綜合應(yīng)用對心衰患者的臨床意義[J];河北醫(yī)學(xué);2006年04期

2 張麗娜;艾宇航;劉志勇;馬新華;明廣峰;趙雙平;徐道妙;;靜動脈血二氧化碳分壓差值在膿毒癥早期目標液體復(fù)蘇中的意義[J];中南大學(xué)學(xué)報(醫(yī)學(xué)版);2012年04期

3 唐繼海;黃文方;李崢嶸;劉蔚;程余恒;;生化檢驗分析中肝素鈉抗凝血漿應(yīng)用的可行性分析[J];檢驗醫(yī)學(xué)與臨床;2012年13期

4 李文峰;康向飛;崔亞男;楊立山;;早期血乳酸與中心靜脈血氧飽和度對膿毒癥休克患者預(yù)后的影響[J];寧夏醫(yī)學(xué)雜志;2012年06期

5 舒?zhèn)ヤh;應(yīng)可凈;方X;李國輝;毛敏杰;;監(jiān)測ScvO_2在COPD并發(fā)呼吸衰竭患者中的臨床應(yīng)用[J];全科醫(yī)學(xué)臨床與教育;2007年05期

6 葛麗英,洪慧東;動靜脈血鉀濃度之間的差異及其原因[J];中華護理雜志;2002年08期

7 王媛媛;蘇美仙;;中心靜脈血氧飽和度在危重病患者救治中的應(yīng)用進展[J];醫(yī)學(xué)綜述;2013年18期

本文編號：2399267