创伤患者呼气末和动脉血二氧化碳分压的关系

Correlation between end-tidal carbon dioxide tension and arterial carbon dioxide pressure in traumatic patients

目的 研究创伤患者呼气末二氧化碳分压 (PetCO2 )和动脉血二氧化碳分压 (PaCO2 )间的关系。 方法 分别测定 18例择期手术患者 (Ⅰ组 )及 36例创伤患者的PaCO2 及PetCO2 ,其中估计失血量 <2 5 %的为Ⅱ组 (18例 ) ,失血量≥ 2 5 %为Ⅲ组 (18例 )。 结果 正常血容量及失血量 <2 5 %的患者 ,PetCO2 和PaCO2 之间差异无显著性意义 (P >0 .0 5 ) ,PetCO2 能可靠反映PaCO2 ;而失血量超过 2 5 %的患者 ,PetCO2 和PaCO2 差异有非常显著性意义 (P <0 .0 1) ,此时PetCO2 不能可靠反映PaCO2 。 结论 在临床上对失血量 <2 5 %的创伤患者 ,可用PetCO2 推断PaCO2 ,但对失血量≥ 2 5 %的创伤患者 ,PetCO2 不能可靠反映PaCO2 。

Objective To investigate the relationship between end-tidal carbon dioxide tension (PetCO 2) and arterial carbon dioxide pressure (PaCO 2) in traumatic patients. Methods PetCO 2 and PaCO 2 were measured in 18 patients undergoing selective operation (Group Ⅰ) and in 36 undergoing emergency operation. All the patients were under general anesthesia. The traumatic patients with bleeding less than 25% were used as Group Ⅱ and those with bleeding over 25% as Group Ⅲ. Results There was no significant difference between PetCO 2 and PaCO 2 in the first two groups (P>0.05). PetCO 2 was a reliable index reflecting PaCO 2. There was a significant difference between PetCO 2 and PaCO 2 in the Group Ⅲ (P<0.01), when PetCO 2 could not reflect PaCO 2 reliably. Conclusions In clinical, we can deduce PaCO 2 using PetCO 2 for patients with bleeding less than 25%. However, PetCO 2 can not reliably reflect PaCO 2 for patients with bleeding over 25%.