呼气末二氧化碳分压监测在全麻拔管后苏醒期患者中的应用  

Application of end-tidal carbon dioxide partial pressure monitoring to postoperative extubated patients during emergence from general anesthesia

作　　者：代恒茂 明伟 周志强 陈罡[1] 刘尚昆 余遥[1] Dai Hengmao;Ming Wei;Zhou Zhiqiang;Chen Gang;Liu Shangkun;Yu Yao(Department of Anesthesia,Tongji Hospital,Tongji Medical University,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030

出　　处：《护理学杂志》2022年第12期36-38,共3页Journal of Nursing Science

摘　　要：目的探讨呼气末二氧化碳分压监测在全身麻醉拔管后苏醒期患者中的应用效果。方法选取全身麻醉手术结束拔除气管导管转入麻醉后苏醒室观察的320例患者为研究对象,采用随机数字表法分为对照组和观察组各160例。对照组常规单孔鼻导管吸氧3 L/min并持续监测心电图、呼吸、无创血压、血氧饱和度;观察组在对照组基础上持续监测呼气末二氧化碳分压数值和波形的变化并及时给予护理干预。比较两组低氧血症发生情况、高碳酸血症和呼吸暂停检出率、面罩加压给氧率和苏醒时间。结果观察组低氧血症程度、面罩加压给氧率显著低于对照组,高碳酸血症、呼吸暂停检出率显著高于对照组,苏醒时间显著短于对照组(P<0.05,P<0.01)。结论对麻醉后苏醒期拔除气管插管的患者,呼气末二氧化碳分压监测可及时发现呼吸暂停、高碳酸血症等呼吸异常事件,降低低氧血症的发生率,提高麻醉苏醒的安全性,缩短苏醒时间。Objective To observe the effect of end-tidal carbon dioxide partial pressure(PetCO_(2))monitoring in postoperative extubated patients during emergence from general anesthesia.Methods A total of 320 postoperative patients who were transferred to the post-anesthetic care unit(PACU)after extubation were randomly and evenly divided into 2 groups.The control group received routine oxygen inhalation through a single-hole nasal catheter at 3 L/min,and was subjected to continuous monitoring of ECG,respiration,non-invasive blood pressure and SpO 2.On top of these measures,continuous PetCO_(2) monitoring was added to the intervention group.The incidence rate of hypoxemia,the detection rate of hypercapnia and apnea,the frequency of mask pressurization and the recovery time were compared between the two groups.Results The severity of hypoxemia,the rate of mask pressurization in the intervention group were significantly lower than those in the control group;the detection rates of hypercapnia and apnea in the intervention group were significantly higher than those in the control group;the emergence time in the intervention group was significantly shorter than that in the control group(P<0.05,P<0.01).Conclusion The application of PetCO_(2) monitoring in postoperative patients after extubation during general anesthesia recovery period can detect respiratory abnormalities such as apnea and hypercapnia in time,reduce the incidence of hypoxemia,improve the safety of the anesthesia recovery period and shorten the recovery time.

关 键 词：全身麻醉 苏醒期 呼气末二氧化碳分压监测 低氧血症 呼吸暂停 高碳酸血症 苏醒时间 麻醉护理 

分 类 号：R472.3[医药卫生—护理学]