机械通气对胸腔内脉搏氧饱和度的影响  

The Impact of Mechanical Ventilation on Pulse Oximetry in Thoracic Cavity

作　　者：李书平[1] 王丽[1] 牟玲[2] 魏蔚[2] 

机构地区：[1]四川省宜宾市第一人民医院,四川宜宾644000 [2]四川大学华西医院麻醉科,四川成都610041

出　　处：《华西医学》2009年第10期2551-2554,共4页West China Medical Journal

基　　金：国家自然科学基金(004020540120)

摘　　要：目的:评价机械通气对胸腔内脉搏氧饱和度的影响。方法:以食道、气管和降主动脉作为胸腔内脉搏氧饱和度的监测位点,将改制后的氧饱和度探头分别固定于上述部位,并连接于同一监护仪上。纯氧通气,待上述氧饱和度容积波波形和读数稳定,停止机械通气30s。以录像的方式记录机械通气停止前后30s内食道、气管和降主动脉SpO2容积波和读数的变化。同时记录舌SpO2。结果:机械通气时,食道、气管和降主动脉三个监测位点均可获得异常高大的SpO2容积波;停止通气时,异常高大的氧饱和度波形消失。食道、气管和降主动脉脉搏容积波变异率分别为11.2%,7.4%,30.2%。降主动脉脉搏容积波的变异率明显高于食道和气管(P<0.05)。机械通气停止前后30s内食道、气管和降主动脉的SpO2读数变化无显著差异(P>0.05)。结论:机械通气对胸腔内食道、气管和降主动脉氧饱和度读数无影响,主要影响是脉搏容积波。且各位点间脉搏氧容积波受呼吸的影响不同。Objective：To investigate the impact of mechanical ventilation on pulse oximetry in thoracic cavity.Methods：After dogs anesthesia induction and thoracotomy,pulse oximeters were simultaneously placed at esophagus,trachea,and descending aorta,and connected with the same monitor for SpO2 monitoring.During ventilation with 100% oxygen,the mechanical ventilator was temporarily switched off for 30 seconds after high quality PPG waveforms and SpO2 readings were obtained.SpO2 signals and readings from esophagus （SeO2）,trachea （StraO2）,descending aorta （SDAO2） shown on the monitoring screen were recorded by the SONY video before and after stop-ventilation.And StonO2 were also recorded.Results：Abnormally large-amplitude PPG waves were found in normal waves at monitoring sites of esophagus,trachea,and descending aorta in all animals during ventilation;however,they disappeared without ventilator.The variation rate in ventilation-induced PPG amplitude were 11.2%,7.4%,30.2% at esophagus,trachea and descending aorta respectively.The PPG amplitude variation rate from SDAO2 was higher than that from SeO2 and StraO2 （P〈0.05）.However,the SpO2 readings obtained from pulse oximetries in all sites were no significantly statistical difference within 30s before and after temporarily stop-ventilation （P〉0.05）.Conclusion：Abnormally amplitude PPG waveforms from oximetry probe placed at esophagus,trachea,and descending aorta were induced by ventilation.The Variation rate in ventilation-induced PPG amplitude was various at different monitoring sites.The SpO2 readings from esophagus,trachea,and descending aorta were not significantly contaminated by ventilation.

关 键 词：机械通气 脉搏氧饱和度 食道 气管 降主动脉 

分 类 号：R614[医药卫生—麻醉学]