推荐回答(2个)
氧分压
英文名称: Partial Pressure of Oxygen
英文又名: pO2
简介
【参考值】
9.98~13.30kPa(75~100mmHg)
【分析变异】
pO2的误差一般不应超过5mmHg,CV小于3.1%。
【生物学变异】
pO2随年龄增长而下降,老年人pO2及O2Sat明显下降;体位变化pO2有轻微改变;长期吸烟者pO2下降;大气压低时pO2也低,高山缺氧时pO2明显下降;剧烈运动健康人pO2略上升。
【药物影响】
肺梗塞病人使用尿激酶治疗可见pO2增高;巴比妥盐、杜冷丁、海洛因、异丙肾上腺素等在慢性疾病应用时可使pO2降低10mmHg左右。
【病理学变异】
病理性的pO2下降主要见于各种疾病所致的低氧血症,一般pO2小于55mmHg。可见下列情况:
呼吸中枢功能减退,如特发性肺泡通气不足综合症、脑炎、肺出血、脑外伤、甲状旁腺功能减退、CO2麻醉或镇静药过量或中毒等。
神经肌肉疾患,如颈椎损伤、多发性硬化症、重症肌无力、肌萎缩等。
胸廓及横膈疾患、肋骨骨折、脊柱严重弯曲、横膈麻痹、急性胰腺炎、高度胸水、极度肥胖症等。
慢性气管炎、肺气肿、支气管哮喘、肺梗塞、心衰等也可造成低氧血症。
呼吸衰竭分度表
项 目 轻度衰竭 中度衰竭 重度衰竭
氧饱和度(%) 80~90 60~80 小于60
pO2(mmHg) 50~55 40~50 30~40
pCO2(mmHg) 55~70 70~90 大于90
血液二氧化碳分压: 指血液中物理溶解的C02所产生的压力。这是判断呼吸性酸、碱中毒的指标,也可帮助了解肺泡的通气情况,
[英文缩写]PCO2
[参考值]
动脉血二氧化碳分压(PaCO2):4.67~6.00kPa(35~45mmHg)
静脉血二氧化碳分压(PvCO2):5.30—7.30kPa(45~55mmHg)
[临床意义]
1.病理性增高:
(1)呼吸性酸中毒时,肺通气不足,致二氧化碳储留。
(2)代谢性碱中毒代偿期,由于体内碱性物质囤积过多,使机体代偿性肺通气减慢,二氧化碳储留。
2.病理性降低:
(1)呼吸性碱中毒时,肺通气过度,致二氧化碳排出过多。
(2)代谢性酸中毒代偿期,由于体内酸性物质囤积过多,使机体代偿性肺通气加快,二氧化碳排出过多。
二氧化碳分压(paco)高于6.7
kpa(5
0
mmhg),i型呼吸衰竭时二氧化碳分压正常或降低
(1)标准碳酸氢根(sb)系指在38℃
pacoz为5.3
kpa(40
mmhg)血氧饱和度为100即呼吸因素完全正常)时所测得血浆中hco之数值单纯反映代谢因素的改变正常值
24(1-27)mmol/l在呼吸性酸中毒时sb保持不变
(2)实际碳酸氢根(hc0-ab人是直接自血浆测得的数据反映代谢方面的情况但溶解的二氧化碳增减对hco3有一定影响正常值24(21-27)mmol/l呼吸性酸中毒时hcoi将发生代偿性增多
(3)缓冲碱门(bb)指血液中有缓冲作用的阴离子总和正常值42(40-44)mmol/l
(4)剩余碱门(be)在38℃二氧化碳分压力5.3kpa(40的人血氧饱和度l.l条件下将血液滴定至ph7.4所需要的酸或碱量它是人体谢性酸碱失衡的定量指征正常值为0(±3
mmol/l)代谢性酸中毒时负值增大;代谢性碱中毒时正值增长
(5)血氧饱和度:即血红蛋白含氧的百分数正常值为97%作为缺氧指标没有氧分压灵敏氧分压明显低于
8
kpa(60)时血氧饱和度才有显著改变易掩盖缺氧的临床
症状
(6)p50:是在
ph=7.40pacoz=5.3
kpa(40
rnlnhg)条件下氧饱和度为
0.50时血氧分压的数值它表明氧解离曲线的位置反映血流运输氧的能力和血红蛋白对氧的亲合力正常值为3.5(3.2-3.7kpa[26(24~28)mmhg]氧解离曲线右移时民增加曲线左移时po减低
(7)px:指在phpaco恒定情况下从每升血中取出2.3inlnol氧的氧分压正常的动静脉的氧含量之差为2.3
rnlnndl因此px值反映混合静脉血的氧分压反映组织供氧情况
正常值为4.5
kpao4
t人
px低于4.5
kpa表明组织缺氧
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