机械通气患者呼气末二氧化碳分压监测异常的原因分析及护理

The nursing of the mechanical ventilated patients with PetCO_2 monitoring

目的:分析影响机械通气患者呼气末二氧化碳分压(PetCO2)监测异常的原因,及时发现异常情况,判断患者病情发展,提高机械通气治疗效果。方法:对2006年1月～2008年12月收治本院ICU治疗的108例机械通气的患者进行PetCO2监测的数值、波形变化情况及其影响因素进行回顾性分析。结果:记录到8种212次PetCO2异常波形和数值,异常发生率为13.40%。其中呼吸环路漏气占30.66%,气管导管位置不当占6.60%,气囊漏气占11.32%,分泌物阻塞占22.17%,通气过度占12.74%,通气不足占7.55%,肺灌注不足占5.66%,机械故障占3.30%。结论:机械通气患者通过持续的监测PetCO2数值和波形曲线变化,结合心电图进行分析,可及时发现异常情况并采取相应处理措施,提高危重患者的救治率。

Objective：To analyse the patient clinical situations and other factors that influence the PetCO-2 monitoring.These analysis can improve the nursing care for mechanical ventilated patients.Method：Retrospective analysis of 212 PetCO-2 monitoring numbers and capnograms in 108 mechanical ventilated patients in our ICU from Jan.2006-Dec.2008.Results：PetCO2 abnormalities rate was 13.40%：leakage in the ventilator system was 30.66%;endotracheal tube malposition 6.60%;endotracheal tube baloon leakage 11.32%;secreations 22.17%;hyperventilation 12.74%;hypoperfusion 7.55%;hypoperfusion of the lung 5.66%;mechanical malfunctioning 3.30%.Conclution：Continue monitoring of PetCO2 and capnogram along with hemodynamic monitoring in mechanical ventilated patients can timely find patient＇s problems and promptly use appropriate interventions.The understanding of these monitoring systems can improve the quality of the nursing care for the critically ill patients.