脓毒症患者PtcO2PtcCO2 的监测意义及对预后的评估作用研究.

To study on the significance of monitoring Noninvasive percutaneous oxygen partial pressure (tcpO2) and carbon dioxide partial pressure (tcpCO2) in sepsis patients and the evaluation of prognosis. 80 patients with sepsis treated in our hospital from January 2016 to December 2018 were selected for the study, the monitoring methods were divided into observation group (n=50) and control group (n=30). Patients in the control group were routinely monitored for arterial blood gas, while patients in the observation group were continuously monitored for percutaneous oxygen partial pressure/carbon dioxide partial pressure. Fluid resuscitation was guided according to relevant data to improve oxygen delivery, and the prognosis of patients was tracked. Analysis of tcpO2, tcpCO2, oxygen migration degree and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) change in sepsis and diagnostic value. Observation group of patients tcpO2, tcpCO2, oxygen migration degree and APACHE Ⅱ were significantly higher than that of control group (P<0.05); Two groups of patients death tcpO2, oxygen migration and APACHE Ⅱ group were significantly higher than survival, while tcpCO2 is lower than the survival group (P<0.05); Logistic regression analysis showed that tcpO2 and tcpCO2 with oxygen migration and APACHE Ⅱ has significant positive correlation (P<0.05); The AUC of tcpO2 in the diagnosis of sepsis was 0.806, and the 95%ci was 0.710~0.902. The AUC of tcpCO2 in the diagnosis of sepsis was 0.723, and the 95%CI was 0.608~0.839. The AUC and 95% ci in the diagnosis of sepsis were 0.970 and 0.938~1.000 respectively. APACHE Ⅱ diagnosis of sepsis in the AUC is 0.932, 95% CI 0.879 to 0.985; The AUC and 95% of combined detection in the diagnosis of sepsis were 0.997 and 0.989~1.000, respectively. The specificity and accuracy of combined detection were 93.74% and 95.68%, respectively, which were significantly higher than the individual detection of each indicator(P<0.05). Early detection of percutaneous oxygen/carbon dioxide partial pressure monitoring device is helpful for early assessment of sepsis severity and prognosis, which is worthy of popularization and application. [ABSTRACT FROM AUTHOR]