俯卧位手术时对PaCO_2和P_(ET)CO_2的影响及相关性分析  

The influence and correlation analysis between PaCO_2 and P(ET)CO_2 in prone position surgery

作　　者：龚发贤 吴芳[1] 张永海[2] 马玲[2] 马汉祥[1] 

机构地区：[1]宁夏医科大学总医院麻醉科,银川市750004 [2]宁夏医科大学

出　　处：《临床麻醉学杂志》2014年第6期574-576,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察俯卧位手术时患者PaCO2和P ET CO2的变化并进行相关性分析。方法选择40例脊柱手术患者，ASAⅠ或Ⅱ级，监测全麻诱导后仰卧位时PaCO2与PET CO2的值作为基础值（T0），再调整为俯卧位，分别监测并记录俯卧位后30min（T1）、60min（T2）和90min（T3）PaCO2与PETCO2，分析PaCO2与P ET CO2的相关性并对各时点PaCO2 （y）和P ET CO2（x）进行曲线拟合求出方程，计算动脉血-呼气末二氧化碳分压差（Pa-ET CO2）。结果全麻诱导后仰卧位及术中俯卧位时PETCO2与PaCO2有显著的相关性，T0～T3时相关系数分别为r0=0．84，n=0．88，r2=0．84和r3=0．82（P〈0．01）。T0～T3时Pa-ET CO2分别为（5．3±2．1）mmHg、（6．6±2．1）mmHg、（5．8±2．2）min Hg和（5．9±2．1）min Hg。T0～T3时PaCO2（y）和PET CO2（x）的方程分别为y0=1．1x0＋2．5、y1=1．1x1＋2．3、y2=1．1x2＋2．4、y3=1．1x3＋4．6。结论无论仰卧位还是俯卧位，PET CO2与PaCO2相关性较好，Pa-ETCO2总体变化范围为3．7～8．7mmHg，俯卧位时PerCO2可以作为评估PaCO2的指标。Objective To investigate the correlation between arterial carbon dioxide partial pressure （PaCO2） and end-tidal carbon dioxide partial pressure （PETCO2） in prone position operation and calculate the value of PaCO2 according to the Pro, CO2. Methods Forty patients with ASA Ⅰ or Ⅱ undergoing spinal surgery were selected, and the values of PaCO2 and PET CO2 as basic value （To） after induction of general anesthesia in supine position monitor and record the value of PET CO2 and PaCO2 in prone position after 30 min （T1）, 60 min （T2） and 90 min （T3）. The correlation between PaCO2 and PET CO2 in each time point were analyzed, and the equation of PaCO2 （y） and PET CO2 （x） with curve fitting and difference of PaCO2 and PETCO2 were calculated. Results There was significant correlation between PaCO2 and PET CO2 in the supine and prone position, their correlation coefficients were r0=0.84, r1=0. 88, r2=0.84, r3=0. 82 （P〈0.01）. The Pa-ET CO2 was （5.3±2. 1） （To） in supine position and （6.6± 2.1） mmHg （T1）, （5.8 ±2.2） mmHg （T2）, （5.9 ±2.1） mmHg （T3） in prone position. The equation in each time point PaCO2 （y） and P ET CO2 （x） were y0 = 1.1x0 ＋ 2.5, y1 =1.1x1 ＋2. 3, y2 =1.1x2 ＋2.4, y3 =1.1x3 ＋4.6, and the Pa-ET CO2 was 3.7-8. 7 mm Hg. There was no significant difference between PaCO2 and P et CO2 at T1-T3. Conclusion Whenever in prone position or supine position, PET CO2 and PaCO2 have significant correlation in prone position and supine position. The overall range of Pa-ETCO2 is 3. 7-8. 7 mm Hg, and the PET CO2 can be as indicator to estimate PaCO2 in prone position.

关 键 词：动脉血二氧化碳分压 呼气末二氧化碳分压 俯卧位 

分 类 号：R614[医药卫生—麻醉学]