呼气末二氧化碳分压监测在心脏骤停救治过程中的应用分析

Application of end-tidal carbon dioxide partial pressure monitoring in the treatment of cardiac arrest

目的分析在成年心脏骤停患者的救治“生存链”中呼气末二氧化碳分压（PETCO2）的变化情况，探讨其在救治过程中的临床意义。方法选取本院2014年1月～2016年2月救治的成年心脏骤停患者80例，在救治过程中常规给予PETC02监测。根据救治效果分为两组，32例患者自主循环恢复（ROSC）为观察组，48例患者未出现自主循环恢复为对照组，比较两组患者不同时间点PETC02的实测值及变化情况。根据自主循环持续时间，将观察组分为两组，18例患者于24h内死亡为甲组，14例患者存活大于24h为乙组，比较两组患者不同时间点PETC02的实测值及变化情况。结果对照组患者PETC02先升高后降低，观察组患者PETCO2持续升高，观察组患者PETCO2在多个时相点明显高于对照组，差异有统计学意义（P〈0．05）：甲组与乙组患者PETCO2均持续升高，乙组患者PETC02在多个时相点均明显高于甲组，差异有统计学意义（P〈0．05）。结论在成年心脏骤停患者的救治“生存链”中，PETCO2与患者预后密切相关，可作为成年心脏骤停患者预后的有效监测指标。

Objective To analyze the change situation of end-tidal carbon dioxide partial pressure （PETCO2） in the treatment＂survival chain＂of adult cardiac arrest patients, and to explore the clinical significance during the treatment process. Methods 80 cases of adult cardiac arrest patients were selected as the objects,which were cured in our hospital from January 2014 to February 2016. End-tidal carbon dioxide partial pressure monitoring was routinely used in the course of treatment. According to the treatment effect, they were divided into two groups.32 cases of patients with spontaneous circulation recovery （ROSC） were in observation group, and 48 cases of patients not appeared spontaneous circulation recovery were in control group. Measured values and change situation of PETCO2 at different time points of the two groups were compared.According to the duration of spontaneous circulation, the observation group was divided into two groups.18 cases of patients died within 24h were group A.14 cases of patients survived more than 24h were group B.Measured values and change situation of PETCO2 at different time points of the two groups were compared.Results The values of PETCO2 of control group were increased first and then decreased.The values of PETCO2 of observation group were sustainably increased.The values of PETCO2 at many time points of observation group were significantly higher than those of control group.The differences were statistically significant （P 〈 0.05）. The values of PETCO2 of Group A and group B were sustainably increased.The values of PETCO2 at many time points of group B were significantly higher than those of group A. The differences were statistically significant （P 〈 0.05）. Conclusion In the treatment ＂survival chain＂ of adult cardiac arrest patients,PETCO2 is closely related to the prognosis of patients.It can be an effective monitoring index for the prognosis of the patients with cardiac arrest.