血气分析深入图像在新生儿肺炎病人中的应用（附40例报告）

为了提高对低氧血症状态的分析和动脉血供氧能力的判断，对４０例出生后１ｈ至１５ｄ住院的新生儿肺炎病人的血气分析数据进行了深入图像分析．均采取股动脉或桡动脉血，检测用丹麦产ＡＢＬ６２０型血气分析仪，试剂及计算机软件全部由丹麦雷度公司提供．４０例中，ＣｔＯ２（动脉血氧含量）下降２９例（７２．５％），ＳＯ２（血氧饱和度）下降２０例（５０．０％），ｐＯ２ａ（动脉血氧分压）下降２５例（６２．５％）．在ｐＯ２ａ正常的１５例中经深入图像分析有８例Ｐｘ（氧张力）均低于正常，这表明低血氧症的实际例数应为３３例，占总数的８２．５％．４０例中ｃｔＨｂ（总血红蛋白）下降１９例（４７．５％），ｃｅＨｂ（有效血红蛋白）下降２２例（５５．０％），Ｏ２Ｈｂ（氧合血红蛋白）正常仅１１例（２７．５％）．４０例中３５例（８７．５％）Ｐ５０下降，氧离曲线左移，表明血红蛋白释氧能力下降，３３例（８２．５％）Ｐｘ低于正常，表明有动脉血释氧能力下降，在临床上需要给氧．

APPLICATION OF THE DEEP PICTURE OF BLOOD GAS ANALYSIS TO THE NEONATES WITH PNEUMONIA

In order to ensure optimal accuracy of diagnosing the hypoxemia and establish the capability of arterial blood to supply oxygen to the tissue, blood gas data of 40 neonates with pneumonia were analyzed with a new program called the deep picture. Femoral or radial arterial blood was measured with ABL blood gas analyzer. The reagents and computer program were supplied by the Danish Radiometer Company. Arterial blood gas analyses show decreased ctO 2 in 29 of all 40 cases (72.5%), decreased SO 2 in 20 cases (50.0%) and decrease p O 2a have in 25 cases (62.5%). The deep picture analysis further shows that 8 of 15 cases with normal p O 2a have lowering P x and P 50 , indicating that there exist really 33 cases, or 82.5 of all 40 cases , with hypoxemia. Moreover, ctHb falls in 19 of 40 cases (47.5%), and ceHb in 22 cases (55.0%). Note that only 11 cases are normal in O 2Hb (27.5%).35 of all 40 cases have decreased P 50 , inducing left shift of the oxygen dissociation curve (ODC), indicating decrease in capability of delivering oxygen of the hemoglobin. In addition, among these 35 cases, there are 34 cases (or 97.1%) with fall in 2,3 DPG, 20 cases (57.1%) with decrease in p CO 2a , 10 cases (28.6%) with increase in pH and only 5 cases (14.3%) with normal body temperature. Finally, P x of 33 cases, or 82.5% of all 40 cases, is lower than the normal value, indicating a decreased oxygen delivery capability of the arterial blood, and suggesting that these neonatal patients must be clinically supplied with oxygen.