论文部分内容阅读
目的评价先天性心脏病患儿经气管导管远端穿刺采样持续P_(ET)CO_2监测方法的可靠性。方法先天性心脏病患儿40例,年龄≤2岁,心肺转流(CPB)下行矫治术。随机均分为两组:P组监测P_(ET)CO_2的气体采样管位于麻醉机螺纹管Y型接头处,D组气体采样管位于气管导管远端(采用22G套管针在邻近气管导管远端穿刺留置)。分别于诱导后15min(T1)及停CPB后15min(T2)记录P_(ET)CO_2监测值;同时采集桡动脉血行血气分析,计算PaCO_2-P_(ET)CO_2值。结果 T1、T2时两组PaCO_2比较均无统计学差异(P>0.05),P组P_(ET)CO_2均低于PaCO_2(P<0.05),D组P_(ET)CO_2与PaCO_2比较均无统计学差异(P>0.05),P组PaCO_2-P_(ET)CO_2值较D组增加(P<0.05)。T1、T2时,D组P_(ET)CO_2与PaCO_2均呈高度正相关(r=0.92、r=0.92,P<0.05)。结论婴幼儿经22G套管针气管导管远端穿刺法持续监测P_(ET)CO_2更为可靠,能准确反映PaCO_2的变化。
Objective To evaluate the reliability of continuous monitoring of P_ (ET) CO_2 in children with congenital heart disease through tracheal catheterization. Methods 40 cases of children with congenital heart disease, aged ≤ 2 years, cardiopulmonary bypass (CPB) downstream correction. Randomly divided into two groups: P group monitoring P_ (ET) CO_2 gas sampling tube located in the anesthesia machine thread Y-junction, D gas sampling tube located in the distal end of the tracheal tube (using 22G trocar in the adjacent tracheal catheter far End puncture indwelling). The monitoring value of P_ (ET) CO_2 was recorded at 15min after induction (T1) and 15min after CPB (T2) respectively. At the same time, radial arterial blood gas was collected to calculate PaCO_2-P_ (ET) CO_2. Results There was no significant difference in PaCO_2 between the two groups at T1 and T2 (P> 0.05), P_ (ET) CO_2 in both groups were lower than PaCO_2 (P <0.05), but there was no statistical difference between P_ (ET) (P> 0.05). The value of PaCO_2-P_ (ET) CO_2 in group P was higher than that in group D (P <0.05). At T1 and T2, there was a highly positive correlation between P_ (ET) CO_2 and PaCO_2 in group D (r = 0.92, r = 0.92, P <0.05). Conclusion The continuous monitoring of P_ (ET) CO_2 by 22G trocar ’s endotracheal tube distal puncture is more reliable and can accurately reflect the changes of PaCO_2.