胸腔和呼出气氧和二氧化碳分压测定对气胸脏层胸膜破口闭合的预测价值

目的探讨胸腔和呼出气体氧分压[p（O_2）]及二氧化碳分压[p（CO_2）]对自发性特发性气胸（PSP）患者脏层胸膜破口闭合判断的预测价值。方法确诊为PSP的患者76例,根据胸部X线片观察肺复张情况作为判定脏层胸膜破口是否闭合的金标准进行分组,其中闭合组40例,开放组36例。利用自行研制的呼出气采集器采集患者的呼气末气体,通过胸腔穿刺收集胸腔气体,同时采集桡动脉血,分别测定呼出、动脉血及胸腔气中的p（O_2）和p（CO_2）,并进行相关数据分析。结果闭合组胸腔气p（O_2）低于开放组,p（CO_2）高于开放组（P〈0.05）;2组呼出气和动脉血p（O_2）和p（CO_2）差异均无统计学意义（P...

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Published in天津医药 Vol. 44; no. 1; pp. 26 - 29
Main Author 贾玮 李海娜 李月川 张冬睿 谷松涛 张永祥 马晖
Format Journal Article
LanguageChinese
Published 天津市胸科医院呼吸与危重症医学科 300222 2016
Subjects
二氧化碳分压
开放
敏感性与特异性
早期诊断
氧分压
脏层胸膜
自发性特发性气胸
闭合
脏层胸膜
自发性特发性气胸
闭合
crbon dioxide partial pressure
氧分压
visceral pleura
sensitivity and specificity
early diagnosis
敏感性与特异性
开放
oxygen partial pressure
二氧化碳分压
primary spontaneous pneumothorax
closure
早期诊断
open
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Summary:目的探讨胸腔和呼出气体氧分压[p（O_2）]及二氧化碳分压[p（CO_2）]对自发性特发性气胸（PSP）患者脏层胸膜破口闭合判断的预测价值。方法确诊为PSP的患者76例,根据胸部X线片观察肺复张情况作为判定脏层胸膜破口是否闭合的金标准进行分组,其中闭合组40例,开放组36例。利用自行研制的呼出气采集器采集患者的呼气末气体,通过胸腔穿刺收集胸腔气体,同时采集桡动脉血,分别测定呼出、动脉血及胸腔气中的p（O_2）和p（CO_2）,并进行相关数据分析。结果闭合组胸腔气p（O_2）低于开放组,p（CO_2）高于开放组（P〈0.05）;2组呼出气和动脉血p（O_2）和p（CO_2）差异均无统计学意义（P〉0.05）;闭合组的呼出气/胸腔气p（O_2）比值高于开放组,p（CO_2）比值低于开放组（P〈0.05）;二分类Logistic回归分析显示,呼出气/胸腔气p（O_2）和p（CO_2）比值为PSP脏层胸膜破口闭合的影响因素;ROC曲线分析显示,呼出气/胸腔气p（O_2）的ROC曲线下面积为0.985,敏感度和特异度分别为92.5%和100%,最佳参考值为1.81;呼出气/胸腔气p（CO_2）的ROC曲线下面积为0.867,敏感度和特异度分别为77.8%和85.0%,最佳参考值为0.97。结论测定胸腔气体和呼出气体p（O_2）和p（CO_2）对判断PSP患者脏层胸膜破口是否闭合具有预测价值。
Bibliography:early diagnosis ; sensitivity and specificity ; visceral pleura; closure; open; oxygen partial pressure; crbon dioxide partial pressure; primary spontaneous pneumothorax
Objective To study the predictive value of evaluation in oxygen partial pressure[p（O2）] and carbon dioxide partial pressure[p（CO2）] of pleural cavity to the closure of visceral pleura in primary spontaneous pneumothroax （PSP） pa- tients. Methods Seventy-six hospitalized pneumothroax patients were divided into two groups： closed pneumothroax group （n=40） and open pneumothroax group （n=36）, according to the radiographic information.To collect the expiratory gas by the device which we designed and produced, to collect the gas in the pleural cavity by thoracentesis. To detect the p （02） and p（COs） respectively, and the blood gas analysis of radial artery was done at same time. Results There was significantly low- er value of p （02）of the gas in the pleural cavity in patients of closed pneumothroax than that of open pneumothroax （P 〈 0.05）. The lev
ISSN:0253-9896
DOI:10.11958/59009