腔镜下甲状腺次全切除术中PaCO_2与P_(ET)CO_2的变化及相关性  

Change and Relationship between PaCO_2 and P_(ET)CO_2 duing Endoscopic Thyroidectomy

作　　者：贺丽[1,2] 高鑫 黄凤贞[1,2] 

机构地区：[1]广东医学院附属医院 [2]深圳市西乡人民医院麻醉科,广东深圳518102 [3]佛山市南海华立医院麻醉科,广东佛山528222

出　　处：《中国医药指南》2013年第17期437-438,共2页Guide of China Medicine

摘　　要：目的探讨腔镜下甲状腺次全切除术中PaCO2与PETCO2的变化及相关性。方法选择40例ASAⅠ～Ⅱ级行腔镜下甲状腺次全切除术患者,于充气前5min,充气后10、30、60min和放气后5、20min采集动脉血标本进行血气分析记录PaCO2,同时记录相应时间的PETCO2,求出Pa-ETCO2。结果充气后10、30、60min,放气后5min PaCO2,PETCO2,Pa-ETCO2与充气前相比均明显升高P<0.01。不同时间的PaCO2与P密切相关,呈显著的正相关P<0.01。而放气后20min接近充气前水平,放气后20min PaCO2与PETCO2相关性不显著。结论腔镜下甲状腺次全切除术气腹期间PaCO2与PETCO2均显著增加,PaCO2与PETCO2有较好的相关性,应适当增加通气,充气停止后5min,CO2继续吸收入血,导致PaCO2与PETCO2升高,充气后20min PaCO2与PETCO2相关性不显著。只监测PETCO2不能准确反映PaCO2,术中需定期进行血气分析监测。Objective To assess the change and relationship between arterial peressure of carbon dioxide （PaCO2） and end expiratory partial pressure of carbon dioxide （PETCO2） during endoscopic thyroidectomy. Methods 40 ASA grade I -II patients undergoing endoscopic thyroidectomy were selected. PaCO2 and PETCOz were measured 5rain before endoscopic, 10, 30, 60min after endoscopic and 5, 20min after deflation respectively. Results PaCO2 and PETCO： 10, 30, 60rain after endoscopic and 5min after endoscopic were significantly hinger than those of 5min before endoscopic （P〈0.01）. PaCO2 and PETCOz 20min after endoscopic closed to the level of before endoscopic. Pa-ETCO2 after endoscopic increased obviously. The relation between PaCO2 and PErCO2 was not at 20min after endoscopic. Conclusion PETCO2 call replace PaCO2 well duing endoscopic thyroidectomy. The relation between PaCO2 and PETCO2 is well correlated. But maybe noted that COs is absorbed into blood continnuly and increases continnuly 5rain after endoscopic. PETCO2 20min after endoscopic is not accurateiy reflect the PaCO2. PETCO2 is an imperfect index of PaCO：, Arterial gas analysis monitoring PaCO2 should be used termly during endoscopic thyroidectomy.

关 键 词：腔镜 甲状腺次全切除 PACO2 PETCO2 相关性 

分 类 号：R736.1[医药卫生—肿瘤]