全身麻醉患者拔除气管导管后微旁流P_(ET)CO_(2)与PaCO_(2)的相关性  

Correlation between microstream P ET CO_(2) and PaCO_(2) in patients withgeneral anesthesia after tracheal catheter removal

作　　者：王玥 辜晓岚[2] 王丽君[2] 顾连兵[2] WANG Yue;GU Xiaolan;WANG Lijun;GU Lianbing(Department of Anethesiology,The Sixth Medical Center of PLA General Hospital,Beijing 100037,China;不详)

机构地区：[1]中国人民解放军总医院第六医学中心麻醉科,北京100037 [2]南京医科大学附属肿瘤医院、江苏省肿瘤防治研究所、江苏省肿瘤医院麻醉科,江苏南京210009

出　　处：《中国临床研究》2024年第8期1210-1213,共4页Chinese Journal of Clinical Research

基　　金：江苏省肿瘤医院优才计划(YC201805)。

摘　　要：目的 探讨全身麻醉患者拔除气管导管后微旁流呼气末二氧化碳分压(P_(ET)CO_(2))与动脉血二氧化碳分压(PaCO_(2))的相关性。方法 选择江苏省肿瘤医院2021年1月至5月择期行腹部手术的患者120例,采取随机数字表法将患者分为3组,每组40例,分别经鼻导管不同流量吸氧,低流量组(L组)2 L/min,中流量组(M组)4 L/min和高流量组(H组)6 L/min。在拔除气管导管30 min时记录P_(ET)CO_(2)数值并抽取动脉血测量PaCO_(2),Pearson法分析P_(ET)CO_(2)与PaCO_(2)的相关性。结果 拔管30 min时,三组P_(ET)CO_(2)、PaCO_(2)、RR差异无统计学意义(P>0.05);L组PaO_(2)和SpO_(2)均显著低于M组和H组(P<0.05)。L组、M组、H组微旁流P_(ET)CO_(2)与PaCO_(2)均呈高度相关(r=0.931、0.878、0.838,P<0.01),二者的相关性随着氧流量的升高而降低。结论 PACU内全身麻醉患者拔除气管导管后使用微旁流P_(ET)CO_(2)监测时,在2~6 L/min的氧流量下微旁流P_(ET)CO_(2)与PaCO_(2)均保持高度相关性,可作为评估PaCO_(2)的重要参考。Objective To evaluate the correlation between microstream partial pressure of end-tidal carbon dioxide(P ET CO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))in patients with general anesthesia after tracheal catheter removal.Methods A total of 120 patients in Jiangsu Cancer Hospital undergoing abdominal operation under general anesthesia were selected and randomly divided into 3 groups,with 40 patients in each group.Each group received oxygen through nasal catheter at different flow rates:group L(2 L/min),group M(4 L/min)and group H(6 L/min).After 30 min of tracheal catheter removal,the value of P ET CO_(2) was recorded and arterial blood was drawn to measure PaCO_(2),and the correlation between P ET CO_(2) and PaCO_(2) was analyzed by Pearson.Results At 30 min of extubation,the differences in P ET CO_(2),PaCO_(2),and RR among the three groups were not statistically significant(P>0.05);PaO_(2) and SpO_(2) in group L were significantly lower than those in groups M and H(P<0.05).There was a high correlation between microstream P ET CO_(2) and PaCO_(2) in group L,M and H(r=0.931,0.878 and 0.838,P<0.01),and the correlation coefficients decreased with the increase of oxygen flow.Conclusion When microstream P ET CO_(2) is used to monitor patients under general anesthesia in PACU after tracheal catheter removal,there is a high correlation between P ET CO_(2) and PaCO_(2) at 2-6 L/min oxygen flow,which can be used as an important reference for the evaluation of PaCO_(2).

关 键 词：二氧化碳描记术 氧吸入疗法 肺通气 呼气末二氧化碳分压 动脉血二氧化碳分压 

分 类 号：R614.2[医药卫生—麻醉学]