经皮二氧化碳分压监测在硬质支气管镜下Feng′s EBUS-TBNB中的应用  

Application of transcutaneous carbon dioxide partial pressure monitoring in Feng′s EBUS-TBNB under rigid bronchoscope

作　　者：骆玉兔[1] 孙亚楠 潘家华 万南生[3] LUO Yutu;SUN Yanan;PAN Jiahua;WAN Nansheng(Department of Respiratory and Critical Care Medicine,Taizhou Second People′s Hospital,Jiangsu 225500;Department of Respiratory,Handan City Cixian People′s Hospital;Department of Respiratory and Critical Care Medicine,Tianjin Medical University General Hospital)

机构地区：[1]泰州市第二人民医院呼吸与危重症医学科,江苏225500 [2]邯郸市磁县人民医院呼吸内科 [3]天津医科大学总医院呼吸与危重症医学科

出　　处：《南通大学学报（医学版）》2024年第1期45-48,共4页Journal of Nantong University(Medical sciences)

基　　金：江苏大学医教协同创新基金项目(JDYY2023150)。

摘　　要：目的:探讨经皮二氧化碳分压(transcutaneous partial pressure of carbon dioxide,PtcCO_(2))监测在硬质支气管镜下冯氏气管内超声引导纵隔切开活检(Feng′s endobronchial ultrasound-guided transbronchial node biopsy,Feng′s EBUS-TBNB)中的应用。方法:收集2019年8月—2022年8月期间天津医科大学总医院收治的纵隔疾病患者128例,随机分成Feng′s EBUS-TBNB组和支气管内超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)组,患者均予高频喷射通气行硬质支气管镜下操作及PtcCO_(2)监测,EBUS-TBNA组患者行EBUS-TBNA,Feng′s EBUS-TBNB组患者行Feng′s EBUS-TBNB术,比较两组患者术前(T0)、通气开始时(T_(1))、通气10 min后(T_(2))、通气20 min后(T3)、通气30 min后(T_(4))、通气40 min后(T_(5))、通气50 min后(T_(6))、通气60 min后(T_(7))心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)和PtcCO_(2)的变化。结果:T_(1)~T_(7)时,两组患者HR、MAP和PtcCO_(2)水平均明显高于T0时(P<0.05)。T0~T_(2)时,两组患者HR、MAP和PtcCO_(2)水平比较差异无统计学意义(P>0.05);T3~T_(5)时,Feng′s EBUS-TBNB组HR、MAP和PtcCO_(2)水平均明显高于EBUS-TBNA组(P<0.05);而T_(6)~T_(7)时,两组患者HR、MAP和PtcCO_(2)水平比较差异无统计学意义(P>0.05)。结论:将PtcCO_(2)应用于Feng′s EBUS-TBNB中,可间接反映患者HR、MAP水平变化,值得临床推广应用。Objective:To investigate the application of transcutaneous partial pressure of carbon dioxide(PtcCO_(2))monitoring in Feng′s endobronchial ultrasound-guided transbronchial node biopsy(Feng′s EBUS-TBNB)under rigid bronchoscope.Methods:A total of 128 patients with mediastinal disease admitted to Tianjin Medical University General Hospital from August 2019 to August 2022 were recruited.Patients were randomly divided into Feng′s EBUS-TBNB group and EBUS-TBNA group.All patients were performed with high-frequency jet ventilation and PtcCO_(2)monitoring during the operation.The heart rate(HR),mean arterial pressure(MAP)and PtcCO_(2)of all patients were recorded at different time,before ventilation(T0),beginning of ventilation(T_(1)),10 min(T_(2)),20 min(T_(3)),30 min(T_(4)),40 min(T_(5)),50 min(T_(6))and 60 min(T_(7))after ventilation,respectively,and were compared between two groups.Results:The HR,MAP and PtcCO_(2)of patients at T_(1)-T_(7) in two groups were all higher that of at T0(P<0.05).The comparisons of HR,MAP and PtcCO_(2)of patients at T0-T_(2) between two groups,there were no significant differences(P>0.05).The HR,MAP and PtcCO_(2)of patients at T_(3)-T_(5) in Feng′s EBUS-TBNB group were significantly higher than that of in EBUS-TBNA group(P<0.01).However,there were no significant differences of HR,MAP and PtcCO_(2)of patients at T_(6)-T_(7) between two groups(P>0.05).Conclusion:The applications of PtcCO_(2)monitoring in Feng′s EBUS-TBNB under RB were safe,and could indirectly detect the HR and MAP of patients,and thus is worthy of clinical application.

关 键 词：纵隔疾病 经皮二氧化碳分压 硬质支气管镜 冯氏气管内超声引导纵隔切开活检 心率 平均动脉压 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]