1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller
2、and DS18B20 temperature sensor.血气分析肝胆外科2013-3132013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcompu
3、ter. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.一、穿刺术 1血气分析标本的留取 血样为动脉血或混合静脉血，采集时多选择体表较易扪及或较暴露部位动脉进行穿刺或从动脉留置套采动脉血或经动脉导管采集混合静脉血。注意在抽取动脉血气标本时注射器必须先用肝素稀释液（ 50mg肝素+100ml生理盐水）湿润注射器，并在抽取动脉血样前针尖向上推出多余液体和注射器内残留气泡，否则会干拢结果。选择合适的动脉穿刺部位，一般在动脉搏动最明显处进针采血 2ml。采血后注意
4、立即拔针并将针头斜面刺入橡皮塞内，以免空气进入而影响结果；若注射器内有气泡应尽快排出。将注射器转动，使血液与肝素充分混匀，防止凝血。采集的血气标本宜立即送检，以免结果误差 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature se
5、nsor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.2影响血气分析结果的因素 心理因素： 动脉穿刺取血时患者的心理因素对血气分析结果有一定的影响。如果患者对动脉穿刺恐惧、精神紧张而诱发快速呼吸，则在准备穿刺到穿刺抽出血液的过程，可发生通气过度而导致 PaCO2降低；若患者因害怕疼痛而屏气，则可发生通气不足导致PaCO2升高。为此，穿刺前应向患者说明配合要领，保持平静呼吸，以获
6、得准确的血气分析结果。2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the syst
7、em are AT89C51 microcontroller and DS18B20 temperature sensor. 采血时机： 采血时机要适合。例如患者吸氧会明显影响动脉血气分析结果。要正确了解患者是否出现呼吸衰竭，须停止吸氧 30分钟后再采血进行血气分析。因为使血气平衡约需要 20-25分钟，过早采血将得到错误的结果。2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function o
8、f temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 血标本留取： 使用的注射器内不得留有空气；血标本抽出后应立即将针头插入橡皮塞内使之与空气严密隔绝。因空气PO2为 21.2kPa（ 159mmHg）、 PCO2为
9、0.03 kPa（ 0.23mmHg），如果空气进入血标本内，会使血中 PaO2明显上升、 PaCO2明显降低而出现误差。2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single c
10、hip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 血标本送检时间： 血标本应及时送检。如果不能及时检测，则应将血标本置于碎冰块中（ 0 ）或放入冰箱内贮藏，最长也不能超过 2h。在室温下延时过久，由于血细胞代谢会使血标本的 PaO2降低、 PaCO2升高、 pH值下降。根据检测，血细胞正常的血液在 38 环境中存放 1h， PaCO2会升高 0.7 kPa（5mmHg）， pH值会降低 0.06。2013-3-13 肝胆
11、外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcon
12、troller and DS18B20 temperature sensor.二、体液酸碱平衡的相关概念 PH PaO2 PaCO2 BE SB（ 标准碳酸氢盐） AB（ 实际碳酸氢盐） BB（ 缓冲碱） 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digit
13、al temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.PH PH： 氢离子浓度的负对数，在细胞外液的正常值为： 7.35至 7.45,静脉血比动脉血低 0.03至 0.05。用以表示体液的酸碱度 。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelli
14、gent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.PaO2 正常值： 95-100mmHg 氧
15、合血红蛋白离解曲线 氧合指数 :PaO2/FiO22013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core componen
16、ts of the system are AT89C51 microcontroller and DS18B20 temperature sensor.PaCO2 为血浆中物理溶解的二氧化碳产生二氧化碳分压。它是判断酸碱平衡的一个主要分量。动脉血正常值为： 35-45mmHg， 静脉血较动脉血高 5-7mmHg。 PaCO2同时也是反映病人通气状态的重要参数。在表浅呼吸时，潮气量下降，肺泡有效通气量随之减少，使 PaCO2上升，当 PaCO245mmHg时示通气不足，二氧化碳储留，为呼吸性酸中毒。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces
17、 the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sens
18、or.BE PaCO2为 40mmHg的气体平衡后，将 PH纠正到 7.40所需酸或碱的量。表示血浆的碱储备增加或减少的情况。正常值为： +3-3 mmol/L， 有碱剩余，多为原发性代谢性碱中毒或是呼吸酸中毒的代偿表现。 BE呈负值，缓冲碱减少， BESB， 示有二氧化碳蓄积，为呼吸性酸中毒； AB55mmol/L,示代谢性碱中毒。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the functio
19、n of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.三、体液酸碱失衡 代谢性酸中毒 代谢性碱中毒 呼吸性酸中毒 呼吸性碱中毒 混合型酸碱紊乱 2013-3-13 肝胆外科 N2级培训This paper main
20、ly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 tem
21、perature sensor.代谢性酸中毒 血浆中 HCO3-原发性减少所致。 血气分析： pH PaCO2,SB。2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chi
22、p microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 任何原因引起的体内非挥发性酸积聚或碱性物质丢失，均可导至代谢性酸中毒。 休克、高热、禁食及腹膜炎病人。由于体内酸性产生物堆集、脂肪分解等，使酮体积累，HCO3- 为缓冲这些物质消耗过多所致。 各种消化道瘘使消化液大量丧失，急性肾功能衰竭、酸性或呈酸性药物报入过多均可致代谢性酸中毒。临床中，还可见某些病人因被大量输入生理盐水、林格氏液，造成体内 HCO3-被稀释和 C1- 增多
23、而致的高血氯代谢性酸中毒。2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the sy
24、stem are AT89C51 microcontroller and DS18B20 temperature sensor.治疗原则： 治疗原发病，纠正酸中毒，静脉内输注碱性药液，常用药物如下： NaHCO3:作用迅速，疗效确切。 乳酸钠：进入体液后分离成氢氧化钠和乳酸，前者与酸作用，转化为 NaHCO3和 H2O， 后者在肝脏经氧化转化为 CO2和 H2O， 并释放热量。在组织缺氧或肝功能损害等情况下，特别是在有乳酸性酸中毒时不易采用。 三羟甲基氨基甲烷（ THAM） 氨丁三醇：进入体液后与 CO2 和 H2O结合，或与 H2CO3反应生成 HCO3-，以提高体液的 PH值。能在细胞内、
25、外液同时起作用，而纠正酸中毒。 THAM很快从尿中排出，带走酸性物质，而有利尿作用。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.
26、 The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.注意： THAM具有高度碱性， pH=10， 对组织刺激性大，故静脉滴注如漏出血管外，可引起组织和皮肤坏死、肌肉痉挛等。大量快速输注时可致呼吸抑制、低血压、低血糖及低血钙。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes
27、 the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.代谢性碱中毒 血浆 HCO3-原发性增高所致。 血气分析 :pH,PaCO 2,SB 。 见于有幽门梗阻伴持续性呕吐、长期胃肠减压、大量
28、丧失胃液后，使血浆中 HCO3-相应增高的病人，也见于碳酸氢盐摄入过多或大量输入库存血，使碱性物质在体内堆集时。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip
29、microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.治疗原则： 治疗原发病、纠正碱中毒，口服或输注酸性溶液。一般治疗，予补充等渗盐水和氯化钾；重症病可给予一定量的呈酸性药物，如 2%氯化铵等。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes t
30、he function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.呼吸性酸中毒 血浆 H2CO3原发性增高所致。 血气分析： pH ， PaCO2 ， SB 或不变。 各种原因引起的通气减少均可导致呼吸性酸
31、中毒，如呼吸道梗阻、肺本身疾病等。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of t
32、he system are AT89C51 microcontroller and DS18B20 temperature sensor.治疗原则： 治疗原发病，改善肺泡通气，必要时插入气管插管行机械通气，以排出过多的CO2。 如病情较重，伴有中枢神经系统及心血管系统的症状时，也可给予 NaHCO3静脉滴注。由于 NaHCO3输入后可使血浆 PCO2进一步增高，而恶化病情，故必须保证病人有足够的通气，利于 CO2排出。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperatur
33、e control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 人工通气过度时， PaCO2下降过快，可使HCO3-相对增加而导致细胞外
34、液中毒。如此，不仅易发生低血钾、低血钙症，且可使 CO2经血脑屏障迅速从脑扩散出来，导致中枢性昏迷，甚至死亡。因而在治疗时，要注意使增高的 PaCO2逐渐下降。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor
35、DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.呼吸性碱中毒 血浆 H2CO3原发性减少所致。 血气分析： PH,PaCO 2 ， SB 。 各种原因引起的通气过度均可导致呼吸性碱中毒，常见于休克、高热、昏迷刺激呼吸中枢、代谢亢进及应用人工呼吸器不当的病人。 也见于情绪激动、颅脑损伤早期引起的过度通气。 2013-3-13 肝胆外科 N2级培训This paper mainly i
36、ntroduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 tempera
37、ture sensor.治疗原则： 原发病治疗，对症治疗。给予面罩呼吸，增加对 CO2的再回吸或采用 5%CO2混合气体吸入，可改善症状 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and
38、single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.混合型酸碱紊乱2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control b
39、y using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.（ 1）代谢性酸中毒合并呼吸性酸中毒血气分析： pH， HCO3-， PaCO2。 见于心跳呼吸骤停发生急性呼吸性酸中毒和乳酸及慢性呼吸性酸中毒病人发生中 毒性休克时伴有乳酸酸中毒。 2013-3-13 肝胆外科 N2级培训This paper
40、 mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B2
41、0 temperature sensor.（ 2）呼吸性酸中毒合并代谢性碱中毒： 血气分析： pH或 或不变， HCO3-，PaCO2。 见于慢性阻塞性肺疾患发生高碳酸血引起呼吸性酸中毒的病人。因心力衰竭接受利尿剂治疗时，出现呼吸性酸中毒合并代谢性碱中毒。 2013-3-13 肝胆外科 N2级培训This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control
42、 by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.（ 3）呼吸性碱中毒合并代谢性酸中毒 ： 血气分析： pH或 或不变， HCO3-，PaCO2。 见于因细菌性败血症致急性肾小球坏死时，可合并发生乳酸酸中毒及水杨酸中毒时，引起的代谢性酸中毒；直接兴奋呼吸中枢引起通气增加而致的呼吸性碱中毒。 2013-3-13 肝胆外科 N2级培训
