摘要
目的观察29例重度创伤患者伤后胃黏膜酸度与APACHEⅡ、ISS以及休克指数的关系。方法患者进入ICU即经鼻置入胃张力计,测定胃黏膜二氧化碳张力(PCO2),并通过Henderson-Hasselbalch方程,计算pHi,pHi≤7.32为异常。同步记录患者APACHEⅡ、ISS和休克指数。患者伤后12h及48h重复上述测定。结果在伤后12h,pHi与APACHEⅡ、ISS以及休克指数均无明显相关关系。在同一个时间点,pHi与动脉血乳酸值浓度无明显关系(r=-0.375,P>0.05)。在伤后48h,pHi与动脉血乳酸值及APACHEⅡ呈明显负相关(r值分别为-0.601和-0.572,均为P<0.01),而动脉血乳酸值和APACHEⅡ呈明显正相关(r=0.739,P<0.01)。pHi在伤后48h比伤后12h有明显提高,由7.35±0.09上升到7.38±0.08(P<0.05),而动脉血乳酸值和APACHEⅡ尚无明显变化(P>0.05)。结论在严重多发伤患者,pHi可以早期提供内脏缺血的信息,为预防多器官功能不全提供实用可靠的监测手段。
Objective To measure the relationship between the gastric mucosal pH and APACHE Ⅱ, ISS and shock index in 29 severely injured patients. Methods Gastric tonometry balloon was placed through nasal way for the measurement of PCO2 , which was used in the Henderson-Hasselbach equation to calculate the pHi. pHi ≤ 7.32 was used to differentiate between normal and low pHi. At the same time, APACHE Ⅱ, ISS, and shock index were measured. Above-mentioned measurement was repeated at 12 h and 48h after injury. Results No correlation was found between pHi values and APACHE Ⅱ , ISS, and shock index as well as lactic acidosis at 12 h （ r = - 0. 375,P 〉 0.05 ） , but at 48h, negative correlation was found between pHi values and APACHE Ⅱ , and lactic acid （ r = - 0.572and - 0. 601, P 〈 0.01 for each） while lactic acidlevel was positively correluted with APACHE Ⅱ （ r = 0. 739,P 〈 0.01 ）. Between 12 h and 48 h, pHi was increased from 7.35 ± 0.09 to 7.38 ± 0.08 （ P 〈 0.05 ）, but lactic acid and APACHE Ⅱ were not changed significantly（ P 〉 0.05 ）. Conclusion pHi maybe a signal of early internal organs ischemia,which will provide solid monitoring measure for multiple organ failure.
出处
《中国医药》
2006年第3期154-155,共2页
China Medicine
