腹腔镜手术中呼气末二氧化碳分压监测在临床麻醉中的应用

Application of Monitoring the Partial Pressure of Carbon Dioxide at the End of Expiration in Clinical Anesthesia during Laparoscopic Surgery

目的探讨呼气末二氧化碳分压(PETCO_(2))监测能否准确反映全麻下腹腔镜手术在二氧化碳气腹下动脉血二氧化碳水平。方法回顾性分析2021年1月至2023年2月襄阳职业技术学院附属医院收治的80例全麻下腹腔镜手术患者的临床资料,监测二氧化碳气腹前后患者PETCO_(2)与动脉血二氧化碳分压(PaCO_(2))的变化,分析二者的相关性,同时记录手术期间发现不良事件的能力。结果患者二氧化碳气腹前后PETCO_(2)与PaCO_(2)的变化均有显著性差异(P<0.05);而发现术中不良事件的能力方面,PETCO_(2)灵敏性明显优于PaCO_(2),二者比较有极显著性差异(P<0.01)。结论临床麻醉中应用PETCO_(2)监测全麻下腹腔镜手术可以有效反映二氧化碳水平变化,具有连续性,亦能更及时发现手术中不良事件,有较高的临床价值。

To explore whether the monitoring of end-expiratory partial pressure of carbon dioxide(PETCO_(2))can accurately reflect the level of arterial blood carbon dioxide under carbon dioxide pneumoperitoneum during laparoscopic surgery under general anesthesia.Methods:The clinical data of 80 patients undergoing laparoscopic surgery under general anesthesia admitted to the Affiliated Hospital of Xiangyang Vocational and Technical College from January 2021 to February 2023 were retrospectively analyzed.By monitoring the numerical changes of end-expiratory partial pressure of carbon dioxide(PETCO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))before and after carbon dioxide pneumoperitoneum,the correlation between them was analyzed,and the ability to find adverse events during the operation was recorded.Results:There were significant differences in the values of PETCO_(2)and PaCO_(2)before and after carbon dioxide pneumoperitoneum(P<0.05).On the other hand,the sensitivity of PETCO_(2)was significantly better than that of PETCO_(2)in detecting intraoperative adverse events(P<0.01).Conclusion:The monitoring of end-expiratory carbon dioxide partial pressure in clinical anesthesia can effectively reflect the change of carbon dioxide level in laparoscopic surgery under general anesthesia,with continuity,and can also find adverse events in surgery in time,which has high clinical value.