|
| 经皮二氧化碳监测在肥胖患者行腹腔镜胃旁路术中的应用 |
| Transcutaneous monitoring of carbon dioxide monitor in severe obese patients undergoing laparoscopic surgery |
| |
| DOI： |
| 中文关键词: 经皮二氧化碳监测 肥胖 胃旁路术 麻醉 |
| 英文关键词: Transcutaneous carbon dioxide Obesity Bariatric surgery Anesthesia |
| 基金项目: |
|
| 摘要点击次数: 2749 |
| 全文下载次数: 1160 |
| 中文摘要: |
| 目的：研究肥胖患者行腹腔镜下胃旁路术中经皮二氧化碳分压(PTC CO 2)监测评估PaCO 2的准确性和相关性。方法择期行腹腔镜下胃旁路术的患者22例,男9例,女13例,年龄19~55岁,体重86~160 kg,BMI>35 kg/m2,ASA Ⅰ或Ⅱ级,在麻醉后(气腹前)和气腹后30、60和120 min 时测量 PaCO 2、PET CO 2和PTC CO 2。并计算 PaCO 2-PET CO 2和 PaCO 2-PTC CO 2的差值,采用 Bland-Altman 分析、相关与回归和确切概率法分析 PaCO 2与PET CO 2、PaCO 2与PTC CO 2的线性回归方程和一致性界限(LOA)。结果1例男性患者因麻醉诱导时使用了去氧肾上腺素而被排除出本研究。余患者 PaCO 2-PET CO 2的差值为(10.3±2.3)mm Hg,PaCO 2-PTC CO 2的差值为(0.9±1.3)mm Hg。PaCO 2与 PET CO 2之间的线性回归方程为 PET CO 2=11.58+0.57× PaCO 2(r2=0.64,P <0.01)；PaCO 2与 PTC CO 2之间的线性回归方程为 PTC CO 2=0.60+0.97× PaCO 2(r2=0.89,P <0.01),气腹后30、60和120 min 时PET CO 2和PTC CO 2与 PaCO 2具有明显相关性(P <0.01)。PaCO 2-PET CO 2差值的95% LOA 为(10.3±4.6)mm Hg；PaCO 2- PTC CO 2差值的95%LOA 为(0.9±2.6)mm Hg。结论肥胖患者行腹腔镜下胃旁路术中,PTC CO 2比PET CO 2更精确地评估 PaCO 2。 |
| 英文摘要: |
| Objective To investigate the accuracy and correlation of estimating PaCO 2 using a transcutaneous CO 2 pressure (PTC CO 2 )monitor in severe obese patients undergoing laparoscopic bar-iatric surgery.Methods Twenty-two patients aged 1 9-55 years,weighting 86-1 60 kg,BMI > 35 kg/m2 ,ASA Ⅰ or Ⅱ undergoing laparoscopic bariatric surgery were included in this study.Their PaCO 2 ,PET CO 2 and PTC CO 2 values were measured at 4 time points before and 30 min,60 min and 120 min after pneumoperitoneum and was the difference calculated between each measure (PaCO 2 -PET CO 2 and PaCO 2 - PTC CO 2 ).Agreement among measures was assessed by the Bland-Altman method.Results One patient was eliminated due to the use of vaso-excitor material phenylephrine during anesthesia induction.The average PaCO 2 -PET CO 2 difference was (10.3±2.3)mm Hg.The average PaCO 2 -PTC CO 2 difference was (0.9±1.3)mm Hg.95% of the limits of agreement(LOA) of the average PaCO 2 -PET CO 2 difference was (10.3 ±4.6)mm Hg.The linear regression equation of PaCO 2 -PET CO 2 was PET CO 2 =1 1.58 +0.57 ×PaCO 2 (r2 =0.64,P <0.01 );whereas the one of PaCO 2 -PTC CO 2 was PTC CO 2 =0.60+0.97×PaCO 2 (r2 =0.89,P <0.01).The LOA of 95% aver-age PaCO 2 -PET CO 2 difference was (10.3±4.6)mm Hg,while the LOA of 95% average PaCO 2 -PTC CO 2 difference was (0.9±2.6)mm Hg.Conclusion While undergoing laparoscopic bariatric sur-gery,transcutaneous carbon dioxide monitoring estimates PaCO 2 better than PET CO 2 in patients with severe obesity. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
