单肺通气期间PetCO_2与PaCO_2的相关性分析

Analysis of the correlation between PetCO_2 and PaCO_2 during one Lung Ventilation

目的:探讨胸腔镜手术单肺通气期间呼气末二氧化碳(PetCO_2)监测值与动脉血二氧化碳分压(PaCO_2)的相关性。方法:选取46例年龄20~65周岁,ASAⅠ~Ⅱ级,择期行胸腔镜下肺叶切除和食管癌根治术的患者,在单肺通气后30 min(T1),单肺通气后60 min(T2)记录PetCO_2监测值,同时记录动脉血气分析中PaCO_2的值,并分析两者的相关性。结果:46例单肺通气患者PetCO_2均值(32.250±2.514)mm Hg(1 mm Hg=0.133 3 k Pa)低于PaCO_2均值(37.568±3.374)mm Hg,二者具有显著正相关(r=0.709,P<0.01),在95%一致性范围是(0.0,10.5 mm Hg),3%(3/92)的数值在95%可信区间之外。PetCO_2和PaCO_2在各时间点均存在良好的相关性。PetCO_2和PaCO_2总体线性回归。结论:胸科手术单肺通气期间PetCO_2和PaCO_2具有良好的相关性,可使用用PetCO_2来反映PaCO_2。

Objective To investigate the correlation between PetCO2 and PaCO2 during one lung ventilation（ OLV） for Thoracic surgery. Method Forty-six aged between 20 and 65,ASAⅠ~Ⅱ adult patients undergoing lobectomy or esophageal cancer radical surgery with one lung ventilation were erolled in our study. PetCO2 and PaCO2 were recorded at the same time points of after one lung ventilation 30 min（ T1） and 60 min（ T2） during anesthesia. The correlations among PetCO2 and PaCO2 were analyzed. Results A total of 92 end-tidal and arterialCO2 pairs were obtained from 46 patients. The mean PetCO2（32. 250 ±2. 514 mm Hg）（1 mm Hg = 0. 1333 k Pa） was lower than the corresponding mean PaCO2（37. 568 ± 3. 374 mm Hg）. There was a significant positive correlation between PetCO2 and PaCO2（r =0. 709,P〈0. 01）. The mean of PaCO2-PetCO295% limits of consistency was（0. 0,10. 5 mm Hg）,and 3%（3 /92） of the points were beyond the 95% CI. The PetCO2 and PaCO2 were closely correlated at two time points of T1 and T2. The equations of linear regression were as follows. Conclusion There is a good correlation and consistency between PetCO2 and PaCO2,PetCO2 can reflect PaCO2 timely and accurately in the patients during one lung ventilation.