呼气末CO_2和静脉血CO_2分压对术后恶心呕吐的预测作用

Predictive effects of end-tidal CO_2 and venous CO_2 on PONV

目的评价呼气末CO_2分压(PeCO_2)和静脉血CO_2分压(PvCO_2)对儿童术后恶心呕吐(PONV)的预测作用。方法按随机数字表法将2014年7月至2016年6月接受单侧腹沟股斜疝修复术的患儿88例分为喉罩组43例和面罩组45例,分别采用喉罩和面罩给氧。在5 min和10 min测量两组的PeCO_2、PvCO_2,并分析两者与PONV的相关性。结果所有患儿均顺利完成手术,喉罩组PeCO_2和PvCO_2低于面罩组;喉罩组和面罩组分别有14例(32.56%)和29例(64.44%)患儿出现PONV,喉罩组PONV发生率低于面罩组,组间比较差异有统计学意义(χ~2=8.947,P=0.003);PONV组不同时间点PeCO_2和PvCO_2均高于非PONV组间比较差异有统计学意义(P<0.05);Logistic回归分析表明体质指数(BMI)、5 min PeCO_2、15 min PeCO_2、5 min PvCO_2、15 min PvCO_2五个因素均为PONV的独立相关因素(P<0.05)。结论较高的PeCO_2和PvCO_2与PONV呈正相关,可用于预测PONV的发生,但确切的联系需要更多研究证实。

Objective To evaluate the predictive value of end- tidal CO2（PeCO2） and venous CO2（PvCO2） for postoperative nausea and vomiting（PONV） in children.Methods From January 2013 to June 2016,88 children who were administered unilateral inguinal hernia repair in our hospital were divided into laryngeal mask（LMA） group（n =43） and face mask（FM） group（n =45）.Oxygen was offered by LMA and FM.PeCO2,PvCO2 at 5 min and 10 min in two groups were measured and the correlation between PONV were analyzed.Results The operation were completed successfully in all cases.PeCO2 and PvCO2 of LMA group were lower than FM group.There were 14 patients（32.56%）and 29 patients（64.44%） in the LAM group and FM group complained of PONV（P〈 0.05）.PeCO2 and PvCO2 in PONV group was significantly higher than non- PONV group at different time points（P〈 0.05）.Logistic regression analysis showed that BMI,5 min PeCO2,15 min PeCO2,5 min PvCO2,15 min PvCO2 were independent with PONV.Conclusion Higher levels of PeCO2 and PvCO2 are positively correlated with PONV and can be used to predict the occurrence of PONV,but the exact association needs to be confirmed by more studies.