气管切开术后二氧化碳排出综合征发生的影响因素分析  

Analysis of the influential factors of carbon dioxide discharge syndrome after tracheotomy

作　　者：邓晓聪[1] 李仕晟[2] 杨新明[2] 尹丹辉 李京鲲 王林[2] 李平[2] 黄超[2] 汪斌[2] 

机构地区：[1]海口市人民医院耳鼻咽喉科,海南海口570208 [2]中南大学湘雅二医院耳鼻咽喉头颈外科,湖南长沙410011

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第2期105-108,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金(81402502)

摘　　要：目的讨论气管切开术后二氧化碳排出综合征的发生机理、临床特征及该综合征发生的原因分析。方法对中南大学湘雅二医院耳鼻咽喉头颈外科2005年1月~2010年12月收集的82例上呼吸道阻塞行气管切开术患者的临床资料,包括年龄、性别、呼吸困难持续时间、气管切开术前二氧化碳分压、氧分压、梗阻原因、慢性肺部疾病史、冠心病史、高血压病史进行回顾性分析,分析诱导二氧化碳排出综合征发生的可能原因。结果 82例患者中有15例(18.29%)患者行气管切开术后出现二氧化碳排出综合征。独立样本t检验和卡方分析结果显示年龄、呼吸困难持续时间、气管切开前二氧化碳分压、慢性肺部疾病史、高血压病史5个因素与气管切开术后发生二氧化碳排出综合征有关。Logistic回归模型分析显示发生呼吸困难持续时间是影响气管切开术后发生二氧化碳排出综合征最重要的因素。结论对于长期上呼吸道梗阻慢性呼吸困难的患者,若进行气管切开术,应考虑二氧化碳排出综合征的可能。同时注意了解患者的既往病史并进行血气分析,以避免发生严重并发症并提高治疗效果。Objective To discuss the mechanism of carbon dioxide discharge syndrome after tracheotomy, and to analyze the clinical features and causes of this syndrome. Methods Clinical data of 82 patients received tracheotomy due to upper respiratory tract obstruction were analyzed retrospectively. All the 82 cases were collected from Department of Otolaryngology-Head and Neck Surgery, the Second Xiangya Hospital, Central South University from Jan. 2005 to Dec. 2010. The data included patients＇age, gender, duration of dyspnea, partial pressure of CO2 and 02 before tracheotomy, causes of obstruction, history of chronic lung diseases, coronary heart disease and hypertension. The causes inducing carbon dioxide discharge syndrome were discussed. Results 15 of the 82 patients （ 18.29% ） had carbon dioxide discharge syndrome after traeheotomy. Independent-samples t-test and Chi-Square analysis showed the carbon dioxide discharge syndrome after tracheotomy was related to patients＇ age, duration of dyspnea, partial pressure of CO2 before tracheotomy, history of chronic lung diseases and hypertension. Logistic regression analysis showed that the duration of dyspnea was the most important factor. Conclusions For the patients with chronic upper respiratory tract obstruction for long time, the carbon dioxide discharge syndrome should be taken in mind before traeheotomy. Meanwhile, in order to avoid complication and improve therapeutic effect, the patient＇ s past history should be known and blood gas analysis should be performed.

关 键 词：气管切开术 二氧化碳排出综合征 上呼吸道梗阻 低碳酸血症 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]