动脉血与呼吸末二氧化碳分压差值的临床研究  

Clinical Study of P_(a-ET)CO_2 Difference

作　　者：刘珊珊[1] 李恩有[1] Liu Shanshan;Li Enyou(Department of Anesthesiology,The First Affiliated Hospital of Harbin Medical University,Heilongjiang 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科,150001

出　　处：《医学研究杂志》2019年第1期35-37,68,共4页Journal of Medical Research

基　　金：国家自然科学基金资助项目(30972839)

摘　　要：目的研究动脉血二氧化碳分压(PaCO_2)与呼吸末二氧化碳分压(P_(ET)CO_2)之间的关联以及影响P(a-ET)CO_2差值的因素。方法收集笔者医院2012年3月～2013年11月的所有血气记录,查阅PaCO_2及同步对应的P_(ET)CO_2以及合并的基础疾病等信息;通过纳入和排除标准,将所得数据(n=646),按照手术方式的不同分成骨科、普外科+妇产科、神经外科、腔镜外科与心胸外科手术5组;按照有无基础疾病分成无合并症组(对照组)、慢性阻塞性肺疾病(COPD)组、高血压组、冠心病组、其他肺部疾病组、休克组;研究不同因素对P_(a-ET)CO_2差值的影响。结果动脉血二氧化碳分压(PaCO_2)与呼吸末二氧化碳分压(P_(ET) CO_2)有较好的相关性(r=0.454,P<0.01)。按照术式不同进行分组比较发现心胸外科手术患者PaCO_2、P_(a-ET)CO_2差值与其他各组比较明显增加(P<0.05)。按照有无基础疾病分组发现合并COPD、其他肺部疾病(肺炎、肺挫裂伤等)的患者Pa CO_2、P_(a-ET)CO_2差值明显增加(P<0.05)。结论研究证实了动脉血二氧化碳分压(PaCO_2)与呼吸末二氧化碳分压(P_(ET)CO_2)之间具有较好的相关性。P_(a-ET)CO_2差值的明显增加与心胸外科手术、肺部疾病等有关。Objective To study the correlation between the arterial carbon dioxide pressure(PaCO 2)and the end-tidal carbon dioxide pressure(P ET CO 2),and to analyze the effective factors with the P(a-ET)CO 2 difference.Methods We collected the blood gas analysis record sheets from March 2012 to November 2013 in our hospital,recorded every records of general conditions,arterial carbon dioxide pressure(PaCO 2)and the synchronous End-tidal carbon dioxide pressure(P ET CO 2),and combined the basic diseases,by inclusion and exclusion criteria,selected the data(n=646),on the basis of the difference of surgery methods,classify data into the orthopaedic surgery,the general+maternity,neurosurgery,laparoscopic surgery and cardiothoracic surgery for five groups;according to the difference of complication,classify date into no complication disease groups,Chronic obstructive pulmonary disease(COPD)group,hypertension group,heart disease group,the other pulmonary disease group,and the shock group;analyse the influence of different agents to the P(a-ET)CO 2 difference.Results There was a significant positive correlation between P ET CO 2 and PaCO 2(r=0.454,P<0.01).According to the difference of disease,surgical methods,we have found that PaCO 2,P(a-ET)CO 2 significantly increased in thoracic surgery group compared with the other groups(P<0.05),pulmonary disease patients with P(a-ET)CO 2 increased significantly(P<0.05).Conclusion The study confirmed that there was a good correlation between P ET CO 2 and PaCO 2.P(a-ET)CO 2 difference associated with thoracic surgery,lung diseases.

关 键 词：呼吸末二氧化碳分压(PETCO2) 动脉血二氧化碳分压(PaCO2) P(a-ET)CO2差值 

分 类 号：R614.2[医药卫生—麻醉学]