无创血红蛋白测定与静脉血红蛋白检测在急诊患者中的比较分析

doi:10.3969/j.issn.1002-1949.2018.09.005

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摘要目的探讨无创血红蛋白（SpHb）监测在急诊患者中的测量准确性，并评估其在急诊科的应用价值。方法应用无创脉搏血氧血红蛋白仪NT1G测定2017-10～2018-01期间就诊于南方医科大学珠江医院的300例急诊患者的SpHb，同时检测其静脉血红蛋白(tHb)，将测量结果进行比较，以评估SpHb准确性。结果对300组数据进行统计学分析，结果显示，SpHb与tHb的Pearson相关系数r=0.862（P＜0.001）,线性回归方程y=-0.239+1.071x，具有显著相关性。Bland-Altman一致性分析显示，SpHb与tHb差值的平均值为-0.59 g/dL，精度为1.09 g/dL，95%一致性界限为-2.73～1.55 g/dL，其偏倚超过了临床可接受范围，一致性较差。在评估输血决策方面，SpHb具有高敏感度、高特异度及高诊断准确率。结论 SpHb与tHb之间具有显著相关性，SpHb可以帮助急诊医师预估tHb的大概值及动态监测变化趋势，对临床输血管理具有良好的指导意义，但一致性不足，SpHb尚不能直接替代tHb。

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	黄伟昌
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关键词 ：无创血红蛋白（SpHb）, 准确性, 输血, 急诊

通讯作者: 刘斌（1967-），男，主任医师，硕士生导师，E-mail：nysylb@163.com。

作者简介: 黄伟昌（1992-),男，硕士研究生，E-mail:13288600178@163.com。

引用本文:

黄伟昌,李奇林,许雪莲，梁志浩,刘斌. 无创血红蛋白测定与静脉血红蛋白检测在急诊患者中的比较分析[J]. 中国急救医学, 2018, 38(9): 768-773.
Huang Wei-chang, Li Qi-ling, Xu Xue-lian, Liang Zhi-hao， Liu Bin. Comparison between noninvasive hemoglobin(SpHb) monitoring and venous hemoglobin measurement in emergency department patients. Chinese Journal of Critical Care Medicine, 2018, 38(9): 768-773.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.09.005 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I9/768

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