经食管监测动脉血氧饱和度安全性的实验研究

Security of transesophageal arterial oxygen saturation monitoring:an experimental study

目的评价经食管监测主动脉血氧饱和度(SteO2)的方法的安全性。方法健康杂种犬21条随机分为3组,A组(n=7):电刀、电凝组(术中使用电刀、电凝);B组(n=7):电除颤组(术毕使用电除颤)。两组又各按发射点和接收点分为A1、A2及B1、B2两个亚组。C组(n=7):实验对照组,麻醉及手术方法同前两组,不行SteO2监测。麻醉诱导后将Nellcor(D-20)探头置入食管下段,连接PM-9000便携式多参数监护仪,调整探头位置,使脉搏波和数值与外周测量数值一致,连续监测SteO2。另用相同型号监护仪连续监测犬舌黏膜血氧饱和度(SmO2)。行开胸手术分离食管,术中使用高频电刀或电击除颤,3h取发生器与接收探测器放置处的食管黏膜组织作病理学检查。结果与C组相比,A、B两组食管黏膜有轻度水肿(P<0.05),无明显损伤/灼伤。结论经食管监测主动脉血氧饱和度是安全的,无灼伤坏死之虑,可作为外周SpO2监测时的另一监测点。

[Objective] To value the security of the method of monitoring aortal oxygen saturation transesophageally （SteO2）. [Methods] 21 healthy hybrid dogs were divided into 3 groups randomly： Group A （n =7）： during operation electrome and electric coagulation was used; Group B （n =7）： at the end of the operation,electric defibrillation was used. And both two groups were divided into two subgroups according to emission point and receive point. Group C （n =7） control group： in this group, anaesthesia and surgical methods were same with group A and B, but without moitoring SteO2. After anesthesia induction; the probe-Nelleor （D-20） was put into the inferior segment of the esophagus, and connected it to mobile multiparameter monitor （PM-9000） monitoring SteO2 consecutively, then adjusted the position until the wave and figure were all equivalent to peripheral saturation of blood oxygen. Another the same monitor was used to monitor saturation of blood oxygen of lingual mucous membrane （SmO2）. After 3 hours＇ thoracic surgery, esophageal mueosa which was linked to the generator and receiver detector was taken for histopathological examination. During the operation, esophagus was separated and high-frequency eleetrome or defibrillation was used.[Result] Compared with group C, esophageal mueosa of group A and B was mild edema without apparent injury/burn （P 〈0.05）. [Conclusion] Monitoring aortal oxygen saturation transesophageally is safe, and can be used for another monitoring site of monitoring SpO2 and the anxiety of burn and necrosis is out of concern.