PETCO2监测判断食管-气管联合导管通气功能的价值

Significance of P_(ET)CO_2 monitoring during ventilation with esophageal-tracheal combitube

目的研究PETCO2监测快速判断食管-气管联合导管和普通气管导管通气是否正常。方法全麻下腹腔镜胆囊切除术（LC）患者48例,随机均分为四组：联合导管食管腔通气组（A1组）,联合导管气管腔通气按压上腹部组（A2组）,联合导管气管腔通气不按压上腹部组（A3组）,气管导管气管通气组（B组）。除常规监测SpO2外,记录四组的PETCO2及波形变化。结果A1、B组显示正常数值及波形;A2组3 min内始终显示为0,CO2波形为直线;A3组在第1分钟显示为0,无CO2波形,第2分钟开始显示为8-9 mm Hg的数值,并有小的CO2波形。结论PETCO2可以较为准确、快速、有效地判断气管插管位置和通气是否正常。

Objective To evaluate whether ventilation with esophageal-tracheal combitube is in normal status through monitoring PETCO2.Methods Forty-eight patients undergoing selective laparoscoic cholecystectomy（LC） under general anesthesia were randomly divided into 4 groups.Grade A was ventilated with E-TT were subdivided into 3 groups of A1（E-TCT ventilation）,A2（E-TCT ventilation plus abdominal compression）,and A3（E-TCT ventilation without abdominal compression）.Grade B was ventilated with common tracheal tube（TT）.In addition to SpO2,the PETCO2 and CO2 waveforms were monitored.Results Normal PETCO2 value and CO2 waveform were seen in groups of A1 and B.PETCO2 monotoring showed at zero all the time within 3 min with a straight line of CO2 wave,no sooner connected PETCO2 probe than presented normal and same marks and CO2 wave,groups A2 presented nothing,group A3 presented nothing on the monitor in the first minute,presented 8-9 mm Hg and small CO2 wave from the second minute.Conclusion Monitoring PETCO2 can judge whether ventilation with E-TCT is in normal status accurately and quickly.