Qhov sib txawv tseem ceeb ntawm ABG CBG thiab VBG yog qhov kev sim ABG siv cov ntshav los ntawm cov hlab ntsha thaum kuaj CBG siv cov ntshav los ntawm cov hlab ntsha, thiab VBG kuaj siv cov ntshav los ntawm cov leeg.
Kev kuaj ntshav roj tau ua tiav txhawm rau ntsuas qib oxygen thiab carbon dioxide, acid-base tshuav nyiaj li cas, thiab kev ua haujlwm ntawm lub ntsws. ABG, CBG, thiab VBG yog peb hom kev xeem ua tiav rau lub hom phiaj. ABG stands rau arterial blood gas thaum CBG stands for capillary blood gas, thiab VBG stands for venous blood gas. Tawm ntawm peb hom kev xeem, ABG yog qhov kev xeem zoo tshaj plaws. Txawm li cas los xij, vim qee yam ntawm cov neeg mob (qhov hnyav thiab hnub nyoog), CBG thiab VBG tau ua raws li lwm txoj hauv kev.
ABG yog dab tsi?
ABG lossis cov roj ntsha hauv cov hlab ntsha yog ib qho kev ntsuas uas ntsuas qhov sib txawv ntawm cov ntshav txav raws cov hlab ntsha. Hauv ib tus neeg noj qab haus huv, thaum cov ntshav txav mus, dhau los ntawm lub ntsws, cov pa oxygen txav mus rau hauv cov ntshav, thiab cov pa roj carbon dioxide txav tawm ntawm cov ntshav zoo. ABG test muab qhov ntsuas kom muaj nuj nqis thiab zoo rau kev ua haujlwm ntawm lub ntsws kom thauj oxygen mus rau hauv cov ntshav thiab tshem tawm cov pa roj carbon dioxide los ntawm cov ntshav. Kev ntsuas ABG ntsuas ib nrab siab ntawm oxygen, ib nrab siab ntawm carbon dioxide, pH, bicarbonate, oxygen cov ntsiab lus, thiab oxygen saturation.
Daim duab 01: Kev cuam tshuam ntawm ABG
Qhov kev sim no ua tiav txhawm rau ntsuas cov kab mob sib txawv uas cuam tshuam nrog lub ntsws thiab ua pa. Kev kuaj ABG feem ntau yog ua los kuaj mob ua pa nyuaj thiab mob ntsws. Cov kab mob no muaj xws li cystic fibrosis, mob hawb pob, thiab COPD (mob obstructive pulmonary disease). Ntxiv rau qhov no, ABG kuaj tuaj yeem ntsuas qib kev ua haujlwm ntawm lub ntsws, xav tau cov pa oxygen ntxiv thiab ntsuas cov kua qaub-puag cov ntshav ntawm cov neeg mob lub raum tsis ua haujlwm, lub plawv tsis ua haujlwm, thiab tsis muaj ntshav qab zib. Kev kuaj ABG yog ua los ntawm kev nqus ntshav los ntawm cov hlab ntsha, feem ntau los ntawm cov hlab ntsha radial (sab hauv ntawm dab teg). Tab sis cov hlab ntsha femoral thiab cov hlab ntsha brachial kuj tau siv los kos ntshav los kuaj.
CBG yog dab tsi?
CBG lossis capillary ntshav roj yog ib qho kev sim ua rau cov menyuam mos lossis menyuam yaus thiab cov neeg laus uas muaj cov hlab ntsha tawg. Qhov kev ntsuas no ntsuas cov ntsuas tsis xws li oxygen, carbon dioxide, thiab acid-base tshuav nyiaj li cas. CBG yog lwm qhov kev sim rau ABG thiab tsuas yog ua tau thaum kuaj sim nyuaj, tshwj xeeb tshaj yog nyob rau hauv cov menyuam mos, menyuam mos, menyuam yaus, thiab cov neeg laus laus uas muaj cov hlab ntsha tawg. Cov kab mob ua pa hnyav uas tshwm sim hauv cov neeg zoo li no yuav tsum tau kho tam sim ntawd txhawm rau tiv thaiv qhov teeb meem. Yog li ntawd, kev kuaj ntshav capillary yog ib txoj hauv kev tseem ceeb hauv kev kho mob sib txawv.
Daim duab 02: Capillary Blood Gas Exchange
Nyob rau hauv qhov kev xeem no, ntshav yog kos los ntawm punctureing txheej cutaneous ntawm daim tawv nqaij ntawm qhov chaw siab vascularization. Feem ntau, ua ntej qhov kev ntsuam xyuas, qhov chaw vascularized yog warmed mus rau dilate cov hlab ntsha thiab kom ceev cov ntshav khiav. Qhov no kuj txo qhov sib txawv ntawm cov hlab ntsha thiab cov hlab ntsha ntawm cov hlab ntsha. CBG xeem tau ua tiav vim muaj ntau yam laj thawj. Cov no suav nrog kev tsis muaj venous lossis arterial nkag mus rau cov ntshav ntsuas roj, kev nyeem txawv txav ntawm cov pa oxygen transcutaneous, qhov kawg-tidal carbon dioxide qhov tseem ceeb, pulse oximetry qhov tseem ceeb. Tsis tas li ntawd, CBG tau ua kom txo qis ntau cov hlab ntsha thiab cov hlab ntshav los ntawm cov menyuam mos, kom tsis txhob nkag mus rau hauv ventral lossis arterial thiab yog li txo qhov kev pheej hmoo ntawm kev kis kab mob. Kev kuaj CBG muaj ntau yam teeb meem tsis tshua muaj xws li kab mob, paj hlwb puas, hematoma, tawv nqaij tawg, thiab pob txha calcification.
VBG yog dab tsi?
VBG lossis venous ntshav roj yog ib qho kev sim tshuaj uas ua los tshuaj xyuas qhov ua pa thiab cov ntshav acid-base tshuav nyiaj li cas. Qhov no yog ua los ntawm lwm txoj hauv kev rau kev kuaj ntshav ntshav ntshav (ABG) thaum tus neeg tau txo qis pulses vim tsis zoo peripheral ntshav ncig lossis ntshav siab. Nyob rau theem ib txwm, kev kuaj VBG yog ua nrog cov ntshav venous uas tau kos los ntawm cov hlab ntsha.
VBG yog qhov kev sim yooj yim, tshwj xeeb tshaj yog nyob rau hauv cov tsev kho mob hnyav vim cov neeg mob twb muaj lub hauv paus catheter. Hloov pauv cov ntshav venous hauv nruab nrab, VBG kuaj yog ua los ntawm cov qauv peripheral venous (los ntawm peripheral venous catheter) lossis cov qauv sib xyaw venous (los ntawm qhov chaw nres nkoj pulmonary artery catheter). Hloov cov roj ntsha peripheral venous, cov ntshav hauv nruab nrab ntawm cov hlab ntsha yog qhov nyiam dua vim tias lawv sib raug zoo nrog cov roj ntsha hauv cov hlab ntsha thiab tau ua pov thawj los ntawm kev tshawb fawb thiab kev kho mob. Kev kuaj VBG muab venous oxygen nro, carbon dioxide nro, acidity, hemoglobin saturation, thiab serum bicarbonate concentration. Feem ntau, cov qauv ntim yog 01 mL (tsawg kawg 0.5 mL), thiab nws ruaj khov rau 30 feeb.
Qhov Zoo sib xws ntawm ABG CBG thiab VBG yog dab tsi?
- ABG, CBG, thiab VBG yog cov ntshav kuaj ntshav.
- Txhua peb hom kev ntsuas ntsuas cov ntsuas zoo sib xws.
- Qhov ntsuas ntsuas tseem ceeb uas muaj rau tag nrho peb qhov kev sim yog qhov ua tau zoo ntawm lub ntsws rau kev sib pauv roj.
- Tag nrho cov ntshav yog hom qauv rau tag nrho peb qhov kev xeem.
- Txhua peb qhov kev sim siv ib qho piv txwv ntawm 1 mL nrog yam tsawg kawg nkaus ntawm 0.5 mL
Qhov txawv ntawm ABG CBG thiab VBG yog dab tsi?
ABG siv cov ntshav hlab ntsha thaum CBG siv cov ntshav capillary, thiab VBG siv cov ntshav veinous. Yog li, qhov no yog qhov sib txawv tseem ceeb ntawm ABG CBG thiab VBG. ABG yog qhov kev kuaj mob tseem ceeb tshaj plaws. Tab sis vim muaj ntau yam teeb meem hauv kev tau txais cov qauv, CBG thiab VBG yog ob qho kev xeem sib tw ua. CBG yog ua rau cov menyuam mos thiab cov neeg laus uas muaj cov hlab ntsha tawg thiab cov hlab ntsha. VBG muaj ntau thiab siv ntau hauv cov tsev kho mob hnyav.
Cov ntawv qhia hauv qab no nthuav tawm qhov sib txawv ntawm ABG CBG thiab VBG hauv daim ntawv teev npe rau ib sab ntawm kev sib piv.
Summary – ABG vs CBG vs VBG
Kev kuaj ntshav roj ntsuas ntsuas qib oxygen thiab carbon dioxide, acid-base tshuav nyiaj li cas, thiab kev ua haujlwm ntawm lub ntsws. Nrog hom ntshav kos, muaj peb hom kev xeem xws li ABG, CBG, thiab VBG. ABG yog qhov kev kuaj ntshav tseem ceeb tshaj plaws, thaum CBG thiab VBG tau ua tiav raws li kev sim lwm yam. CBG yog ua tiav rau cov menyuam mos thiab cov neeg laus cov neeg mob uas muaj cov hlab ntsha tawg thiab cov hlab ntsha. Lub ntsiab ntsuas ntsuas tsis zoo rau tag nrho peb qhov kev ntsuam xyuas yog qhov ua tau zoo ntawm lub ntsws rau kev sib pauv roj. Tag nrho cov ntshav yog hom qauv rau tag nrho peb qhov kev ntsuam xyuas. Yog li, qhov no yog cov ntsiab lus ntawm qhov sib txawv ntawm ABG CBG thiab VBG.
