血气分析指导全身麻醉控制呼吸的研究

Study on blood gas analysis in directing controlled respiration under general anesthesia

目的评价血气分析对指导全身麻醉机械控制呼吸的意义。方法197例成人全身麻醉患者,机械控制呼吸,呼吸参数设定为:潮气量(VT):8.77±1.21ml/kg,呼吸频率(f):12bpm,吸呼比(I∶E):1:2,新鲜气流量纯氧:2L/min。麻醉后20min及其后每1h进行血气分析,血气分析不正常者,于调整呼吸参数20min后,再次做血气分析。结果第一次血气分析数值:PaCO2平均值为33.45±12.76mmhg,正常率44.7%;PH平均值为7.406±0.0544,正常率65.99.0%。109例PaCO2非正常者,调整VT。第二次血气分析PaCO2平均值为37.11±4.64,PaCO2正常范围者共176例,占89.3%,与未调整前相比有显著性差异(P<0.05)。第二次血气分析PH值平均值为7.384±0.0211,正常范围者共183例,占总数的92.89%,与未调整前相比有显著性差异(P<0.05)。结论血气分析用于指导全身麻醉控制呼吸有重要临床意义。

Objective To evaluate the clinical significance of arterial blood gas analysis in directing controlled mechanical ventilation under general anesthesia. Methods 197 adult patients who received operation under general anesthesia were administered controlled mechanical ventilation. These patients would be set ventilation parameters as follows： VT： 8.77±1.21 ml/kg,f： 12 bpm, I ： E： 1 ： 2, and fresh gas of purified oxygen：2 L/min. Arterial blood gas analysis was made 20 min after anesthesia and per hour thereafter. The patients whose first arterial blood gas analysis values were abnormal were made another blood gas analysis 20 min after adjusting their raspixatory parameters. Results The first blood gas analysis values of the patients showed that the average PaCO2 value was 33.45±12.76 mmhg, only 44.7% were normal. The average PH value was 7.406±0.0544 （65.99% were normal）. 109 cases of first PaCO2 were abnormal which ventilation parameters were adjusted according to their first PaCO2. The second blood gas analysis values of the patients showed that the average PaCO2 value was 37.11 ±4.64 mmhg, 89.3% were normal and higher than the first （P〈0.05）. The average PH value was 7.384±0.0211,92.89% were normal and it was higher than the first （P〈0.05）. Conclusions It has important clinical significance significant for arterial blood gas analysis to direct controlled respiration under general anesthesia.