| The clinical studies on the gastric intramucosal pH ( pHi) are used to judge the hypoxia in tissue level and the ischemia of intemal organs. It is important for the critical patients to carry out the pHi monitoring and to measure the state of systemic oxygenation and low perfusion of tissue and organs before the variation of the clinical state of an illness so as to carrying out the appropriate interference and treatment. One of major goal of the treatment for critical patients is to increase the hypoxia in tissue level and the oxygen supply for the body tissue. The decrease of pHi can indirectly know the chemia of intemal organs and unwoundly influence the alteration of tissue level. The decrease of pHi can point out the mucoral low perfusion and ischemia and hypoxia of tissue early. We have observed 19 critical patients with infused by oxygen-carrying solution (the carbamide hydrogen proxide for injection) and found out a new treatment to improve the hypoxia in tissue level through monitoring pHi. The crinical test have testified that the medicines whould improve the state of tissue hypoxia and systemic oxygenation.Materials and MethodsThe critical patients in ICU,whose APACHE II score is beyond 15, were observed as the objects of researched projects, including the heart-lung recovery postoperations , the serious compound-wounds, the shock of spetic and bleed-ing, ARDS, the great surgical pastoperations(exclude esophagus and stomach) , MODS, the serious heart-lung illness, et al. The major test medicines is carbamide hydrogen peroxide for injection. The equipments is arterial blood gas a-nalysis instrument and stomatch tension pipe. 1. The method of indirect surveying pHi; We used stomach tension pipe to survey the carbon dioxide partial pressure in stomach mucosa, at the same time, we use arterial blood gas analysis instrument to survey the data of arterial blood HCO3-. Thus, we can find the result of level of pHi after this two data is led to the formula of Henderson-Has-selbalch [ pHi = 6.1 ± lg( [ HCO3- ] /0.0307 x PCO2) ]. 2. The method of judging the curative effect of the carbamide hydrogen proxide for injection: The data before infused the carbamide hydrogen proxide for injection are the control group. The data of forth coming time and one hour and two hour after infusion are respectively the test group. 3. Statistic deal: We have compared the control group with the test group through the statistic soft of SPSS11.0. The results were stated with t test. The difference is significant when P <0. 05.Results1. The varieties of pHi before and after injection: The results seperately in instant 1 and 2 hours group after injection have shown that pHi had increased especially in 2 hour group [ seperately 7. 379 ±0.053 (the control group) ;7. 395±0.053(P<0.05) ;7.407 ±0.050(P <0. 01) ;7.408 ±0.049(P <0. 01) ]. 2. The varieties of PaO2 before and after injection: The results seperately in instant 1 and 2 hours group after injection have shown that PaO2 had obviously increased in instant after injection and reached to the summit in 1 hour and began to decreace in 2 hour[ seperately 70.6 ±12. 8mmHg( the control group) ;76.1 ± 16.8mmHg(P<0.01);80.9±19.1 mmHg(P <0.01) ;80.4 ±18.7 mmHg(P<0. 01) ]. 3. The varieties of PaCO2 before and after injection have shown no obvious significance( P > 0.05 ).DiscussionThrough extensive study many scholars have proved that pHi can reflect the state of part tissue oxygenation thereby the state of systemic oxygenation and blood perfusion. Our results consistenting with Gutierrz's show that the pHi increase of critical patients after injection have proved the improvement of gastroi-mtestinal anemia and the effective treament , conversely proved the unhealthly prognosis and the increase of death rate. We should measure not only DO2and VO2but also the tissue pHi so as further to judge the state of an illness and to prevent the shock in the early stage and to unwoundly reflect ischemia of intemal orgens . DO2 and VO2 are the index of syste...
|
PDF Full Text Request