动脉血-呼气末CO_2分压差影响因素分析

MULTI-FACTORIAL ANALYSIS OF ARTERIAL TO END-TIDAL CO_2 TENSION GRADIENT

目的探讨全身麻醉机械通气时,动脉血和呼气末二氧化碳分压差(Pa-ETCO_2)的影响因素。方法择期手术病人401例,经静脉快速诱导气管内插管全身麻醉,麻醉诱导后15min,取动脉血检测动脉血二氧化碳分压(PaCO_2),同时记录相应的呼气末二氧化碳分压(PETCO_2)及Pa-ETCO_2。结果年龄>50岁、体质量指数(BMI)>25kg/m^2、合并肺部疾病、高血压、糖尿病、吸烟史均对Pa-ETCO_2有明显影响(t=2.691~8.136,P<0.05);性别对Pa-ETCO_2无明显影响(P>0.05)。结论肺部疾病、高血压、糖尿病、吸烟史、高龄(>50岁)及BMI(>25kg/m^2)均能明显增大Pa-ETCO_2。

Objective To analyze the influencing factors of arterial to end-tidal carbon dioxide tension gradient under general anesthesia. Methods This study consisted of 401 patients undergoing elective surgery. General anesthesia was performed through rapid intravenous induction and endotracheal intubation. Fifteen minutes after anesthesia induction, arterial blood was taken to measure the arterial partial pressure of carbon dioxide （PaCO2）, and, at the same time, the corresponding end tidal car bon dioxide partial pressure （PETCO2） was recorded, the difference between the two was Pa-ETCO2. Results Age （〉50）, BMI （〉25 kg/m2） , smoking history, complicated with pulmonary disease, hypertension and diabetes had significant effect on Pa- ETCO2（t=2.691-8.136,P〈0.05）, while gender had no effect on Pa-ETCO2（P〉0.05）. Conclusion Pulmonary disease, hy- pertension, diabetes, smoking history, age （〉50）, and BMI （〉25 kg/m2） can significantly increase Pa-ETCO2.