| 老年人单肺通气时呼气末二氧化碳监测的可信度 |
| |
| 引用本文： | 马曙亮,何建华,顾连兵,鲁振,黄凤伦,许林. 老年人单肺通气时呼气末二氧化碳监测的可信度[J]. 临床麻醉学杂志, 2009, 25(12) |
| |
| 作者姓名： | 马曙亮 何建华 顾连兵 鲁振 黄凤伦 许林 |
| |
| 作者单位： | 江苏省肿瘤医院麻醉科,南京市,210009;江苏省肿瘤医院胸外科,南京市,210009 |
| |
| 基金项目： | 江苏省科技发展计划项目 |
| |
| 摘 要： | 目的 观察老年人单肺通气(OLV)麻醉时P_(ET)CO_2C_2和PaCO_2的相关性,以评定P_(ET)CO_2监测在老年人单肺通气麻醉的可信度.方法 37例老年肺部肿瘤患者,胸腔镜下行胸部肿瘤切除、活检或肿瘤根治术,采用静脉复合全麻,术中行OLV.记录麻醉前及OLV 30、60、90、120、180和240min时BP、HR、SpO_2、P_(ET)CO_2和动脉血气,计算氧合指数(PaO_2/FiO_2)、动脉-呼气末二氧化碳分压差(P_(a-ET)CO_2),及对应时间点P_(ET)CO_2和PaCO_2的相关性.结果 除OLV 180 min时点外,术中各时点PaCO_2与P_(ET)CO_2有较好的相关性.术中5例发生低氧血症.结论 老年人OLV麻醉中P_(ET)CO_2不能完全反映PaCO_2的变化,长时间OLV者需同时行血气分析,以保证老年人的安全.
|
| 关 键 词： | 单肺通气 呼气末二氧化碳分压 老年 监测 |
Credibility of end-tidal carbon dioxide partial pressure monitoring in elderly during one-lung ventilation |
| |
| Abstract: | Objective To assess the credibility of end-tidal carbon dioxide-partial pressure (P_(ET)CO_2)monitoring in the elderly during video-assisted thoracic surgery(VATS)under on-lung ventilation(OLV).Methods Thirty-seven elder patients undergoing VATS were given total intravenous anesthesia with OLV by double-lumen endotracheal tubes.Arterial blood gas analysis,P_(ET)CO_2 and hemodynamics were measured.Oxygenation index(OI,PaO_2/FiO_2) and arterial bloodendtidal carbon dioxide partial pressure difference(P_(a-ET)CO_2)were calcurated.Results Except at 180min during OLV,the correlation between P_(ET)CO_2 and PaCO_2 was good.Hypoxemia(OI,SpO_2<90%)during OLV occurred in 5 cases.Conclusion P_(ET)CO_2 can not reflect the changes of PaCO_2 accurately.Arterial blood gas analysis is needed during OLV for a long time in elder patients. |
| |
| Keywords: | One-lung ventilation End-tidal carbon dioxide partial pressure Geriatrics Monitoring |
| 本文献已被 万方数据 等数据库收录！ |
|
