目的 儿童枸橼酸抗凝连续性血液净化(RCA-CBP)治疗过程中,比较管路采血与血管采血的标本在电解质、血糖、血气检测方面的差异,探讨管路采血替代血管采血的可行性.方法 选择2021年7月至2023年7月在郴州市第一人民医院ICU接受RCA-CBP治疗的60例儿童开展研究.采用 自身对照,同时收集患者血管和RCA-CBP治疗管路的血样,比较两种血样电解质、血糖和血气检测结果的差异.结果 管路采血标本与血管采血标本中钠、钾、离子钙和血糖差异无统计学意义(P>0.05);管路采血标本与血管采血标本中血气中酸碱值、剩余碱差异无统计学意义(P>0.001);管路采血标本二氧化碳分压、碳酸氢根和乳酸高于血管采血标本,差异有统计学意义(P<0.05);管路采血标本中氧分压低于血管采血标本,差异有统计学意义(P<0.05);管路采血标本与血管采血标本中Na+、K+、iCa2+、Glu、pH、BE-致性较好.结论 管路采血能够代替血管采血监测电解质、血糖及部分血气分析指标.
Objective To compare the difference in electrolyte,blood glucose,and blood gas detection of samples between pipeline blood collection and vascular blood collection,and we explored the feasibility of pipe-line blood collection to replace vascular blood collection during the processes of regional citrate anticoagulation-continuous blood purification(RCA-CBP)in children.Methods This study was conducted on 60 children who received RCA-CBP treatment in the ICU of The First People's Hospital of Chenzhou from July 2021 to Ju-ly 2023.The differences of the detection results in blood electrolyte,blood glucose and blood gas between pa-tients'blood vessels and RCA-CBP treatment pipeline were compared with self-comparison.Results There was no statistical differences in sodium,potassium,ionized calcium,and blood glucose between pipeline blood collection and vascular blood collection samples(P>0.05);There was no statistical differences in acid-base values and base excess in blood gas of samples between pipeline blood collection and vascular blood collection(P>0.05);Partial pressure of carbon dioxide,bicarbonate radical,and lactic acid were higher in pipeline blood collection samples than the vascular blood collection samples,and the differences were statistically signif-icant(P<0.001);The partial pressure of oxygen in pipeline blood collection samples was lower compared to the vascular blood collection,and the difference was statistically significant(P<0.05);The consistency of Na+,K+,iCa2+,glucose,pH,and base excess was good between pipeline blood collection samples and vascu-lar blood collection samples.Conclusion Pipeline blood collection can replace vascular blood collection to monitor electrolytes,blood glucose,and some blood gas analysis indexes.