平静呼气法与延长呼气法测定呼气末二氧化碳分压在呼吸内科应用价值的比较  

The comparison of the value of end-tidal partial pressure of carbon dioxide after eupnoea and prolonged expiratory method in Department of Respiratory Medicine

作　　者：谭伟[1] 刘璠[1] 侯海佳[1] 代冰[1] 王乾辉[1] 赵洪文[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院呼吸疾病研究所内科ICU,辽宁沈阳110001

出　　处：《中华危重病急救医学》2013年第10期608-613,共6页Chinese Critical Care Medicine

基　　金：辽宁省沈阳市科委社会发展科技攻关项目（FR-193-9-02）

摘　　要：目的探讨平静呼气法与延长呼气法测定呼气末二氧化碳分压（PET02）在呼吸内科的应用价值。方法选择114例住本院呼吸内科的患者，采用平静呼气法和延长呼气法分别测定PET02，并行血气分析。分别根据动脉血二氧化碳分压（PaCO2）水平及原发病将患者分组，对两种方法测定的PET02与PaCO2进行相关性分析。同期选择45例健康志愿者进行对照。结果①健康志愿者平静呼气法、延长呼气法测定的PETCO2[（39．68±5．07）mmHg、（40．68±3．25）mmHg（1mmHg=0．133kPa）]均与PaCO2[（40．44±2．70）mmHg]相关性良好（r1=O．79、P1=13．（12，r2=0．91、P2=0．04）。②114例患者平静呼气法、延长呼气法测定的PETCO2[（35．93±8．19）mmHg、（40．69±10．71）mmHg]均与PaC02[（42．90±12．62）mmHg]相关性良好（r1=0．80，r2=0．86，均P〈0．01）。③PaCO2分组分析：正常PaCO2组（35—45mmHg，49例）平静呼气法、延长呼气法测定的PETC02[（37．64±4．67）mmHg、（38．25±5．03）mmHg]均与PaC02（（39．30±3．10）mmHg]相关性良好（r1=0．76、P1=0．61，r2=0．82、P2=0．65）；低PaCO2组（〈35mmHg，26例）平静呼气法、延长呼气法测定的PETCO2[（28．41±5．63）mmHg、（31．36±5．47）mmHg]均与PaC02[（31．27±5．47）mmHg]相关性良好（r1=0．68，r2=0．87，均P〈0．01）；高PaC02组（45～60mmHg，27例）平静呼气法测定的PETC02[（37．07±5．04）mmHg]与PaC02[（49．51±5．18）mmHg]相关性较差（r=0．42，P=0．02），延长呼气法测定的PETC02[（46．61±3．75）mmHg]与PaC02[（49．51±5．18）mmHg]相关性较好（r=0．81，P=0．01）；极高PaC02组（〉60mmHg，12例）平静呼气法、延长呼气法测定的PETCO2[（51．37±11．25）mmHg、（62．57±16．24）mmHg]均与PaCO2[（74．63±12．20）mmHg]相关性较好（r1=0．80、P1=0．09，r2=0．82，P2=0．11）。④原发病分组：慢性阻塞性肺疾病（COPD）�Objective To compare and discuss the value of end-tidal partial pressure of carbon dioxide （PETCO2） using eupnoea or prolonged expiratory method, and explore their applieation value in department of respiratory medicine. Methods One hundred and fourteen patients admitted to the Department of Respiratory Medicine of hospital received PETC02 monitor, using eihter eupnoea or prolonged expiratory method, and blood gas analysis was performed thereafter. Then the patients were divided into different groups according to different arterial partial pressure of carbon dioxide （PaCO2） and diseases. PETC02 using two methods were compared and performed correlation analysis with PaC02 was performed. A group of 45 healthy volunteers were served as the control group. Results ①In healthy volunteers, PETC02 using eupnoea or prolonged expiratory method was （39.68 ± 5.07） mm Hg （ 1 mm Hg=0.133 kPa）, （40.68 ±3.25 ） mm Hg, respectively, and they showed a good correlation with PaCO2 （ （40.44 ± 2.70） mm Hg, r1=0.79, P1= 0.02; r2=0.91, P2 =0.04）. ② In 114 patients group, PETCO2 using eupnoea and prolonged expiratory method was （35.93 ±8.19） mm Hg, （40.69 ± 10.71） mm Hg, respectively, and they showed a good correlation with PaC02 [（42.90 ± 12.62） mm Hg, r1 =0.80, r2=0.86, both P〈0.01 ）. ③ Subgroup analysis according to different levels of PaCO2： in normal PaC02 group （35-45 mm Hg, n =49 ）, PETC02 using eupnoea or prolonged expiratory method was （37.64 ±4.67） mm Hg, （38.25 ±5.03） mm Hg, respectively, and they showed a good correlation with PaCO2 [（39.30 ± 3.10） mm Hg, r1=0.76, P1=0.61; r2=0.82, P2=0.65]; in low PaC02 group （〈35 mm Hg, n=26）, PETC02 by using eupnoea or prolonged expiratory method was （28.4 ±5.63） mm Hg, （31.3 ±5.47） mm Hg, respectively, and they showed a good correlation with PaC02 [ （31.27 ± 5.47） mm Hg, r1=0.68, r2=0.87, both P〈 0.013; in high PaC02 group （45-60 mm Hg, n =27）, PmC02 by using eupnoea expiratory method [

关 键 词：呼气末二氧化碳分压 慢性阻塞性肺疾病 延长呼气法 

分 类 号：R56[医药卫生—呼吸系统]