目的观察经鼻导管微旁流式呼气末二氧化碳分压(P ET CO2)监测能否预防经内镜逆行胰胆管造影术(ERCP)麻醉期间低氧血症的发生,并探讨其优缺点。方法选取我院肝胆外科2017-03/2019-05期间因胆道结石择期于非气管插管全身麻醉下行ERCP取石...目的观察经鼻导管微旁流式呼气末二氧化碳分压(P ET CO2)监测能否预防经内镜逆行胰胆管造影术(ERCP)麻醉期间低氧血症的发生,并探讨其优缺点。方法选取我院肝胆外科2017-03/2019-05期间因胆道结石择期于非气管插管全身麻醉下行ERCP取石的患者240例,年龄40~65岁,体质量45~75 kg,ASA分级Ⅱ或Ⅲ级,随机分为试验组(经鼻导管吸氧,采用经鼻导管微旁流式P ET CO2监测患者肺通气,n=120)和对照组(仅经鼻导管吸氧,n=120)。两组患者均于置入十二指肠镜前10 min开始泵注瑞芬太尼0.04μg/(kg·min),直至手术结束。置镜前2 min给予丙泊酚1.5~2.0 mg/kg,待睫毛反射消失后置入十二指肠镜,置镜成功后予丙泊酚3~5 mg/(kg·h)持续泵注直至手术结束。观察并比较2组患者低氧血症(SpO 2<90%)发生率、托下颌率、挤压胸廓辅助呼吸率、面罩加压给氧率。结果两组患者性别比、年龄、BMI、手术时间、苏醒时间、丙泊酚用量等一般资料比较,差异无统计学意义(P>0.05);试验组患者低氧血症发生率、面罩加压给氧率低于对照组,差异有统计学意义(P<0.05),试验组托下颌率、挤压胸廓辅助呼吸率高于对照组,差异有统计学意义。结论经鼻导管微旁流式P ET CO2监测可实时指导我们对患者进行托下颌、挤压胸廓辅助呼吸处理,降低ERCP麻醉期间低氧血症的发生率和面罩加压给氧率。展开更多
Geophysical techniques play key roles in the measuring, monitoring, and verifying the safety of CO2 sequestration and in identifying the efficiency of CO2-enhanced oil recovery. Although geophysical monitoring techniq...Geophysical techniques play key roles in the measuring, monitoring, and verifying the safety of CO2 sequestration and in identifying the efficiency of CO2-enhanced oil recovery. Although geophysical monitoring techniques for CO2 sequestration have grown out of conventional oil and gas geophysical exploration techniques, it takes a long time to conduct geophysical monitoring, and there are many barriers and challenges. In this paper, with the initial objective of performing CO2 sequestration, we studied the geophysical tasks associated with evaluating geological storage sites and monitoring CO2 sequestration. Based on our review of the scope of geophysical monitoring techniques and our experience in domestic and international carbon capture and sequestration projects, we analyzed the inherent difficulties and our experiences in geophysical monitoring techniques, especially, with respect to 4D seismic acquisition, processing, and interpretation.展开更多
文摘目的观察经鼻导管微旁流式呼气末二氧化碳分压(P ET CO2)监测能否预防经内镜逆行胰胆管造影术(ERCP)麻醉期间低氧血症的发生,并探讨其优缺点。方法选取我院肝胆外科2017-03/2019-05期间因胆道结石择期于非气管插管全身麻醉下行ERCP取石的患者240例,年龄40~65岁,体质量45~75 kg,ASA分级Ⅱ或Ⅲ级,随机分为试验组(经鼻导管吸氧,采用经鼻导管微旁流式P ET CO2监测患者肺通气,n=120)和对照组(仅经鼻导管吸氧,n=120)。两组患者均于置入十二指肠镜前10 min开始泵注瑞芬太尼0.04μg/(kg·min),直至手术结束。置镜前2 min给予丙泊酚1.5~2.0 mg/kg,待睫毛反射消失后置入十二指肠镜,置镜成功后予丙泊酚3~5 mg/(kg·h)持续泵注直至手术结束。观察并比较2组患者低氧血症(SpO 2<90%)发生率、托下颌率、挤压胸廓辅助呼吸率、面罩加压给氧率。结果两组患者性别比、年龄、BMI、手术时间、苏醒时间、丙泊酚用量等一般资料比较,差异无统计学意义(P>0.05);试验组患者低氧血症发生率、面罩加压给氧率低于对照组,差异有统计学意义(P<0.05),试验组托下颌率、挤压胸廓辅助呼吸率高于对照组,差异有统计学意义。结论经鼻导管微旁流式P ET CO2监测可实时指导我们对患者进行托下颌、挤压胸廓辅助呼吸处理,降低ERCP麻醉期间低氧血症的发生率和面罩加压给氧率。
基金supported by National 863 Program Grant 2012AA050103 and Grant 2011KTCQ03-09
文摘Geophysical techniques play key roles in the measuring, monitoring, and verifying the safety of CO2 sequestration and in identifying the efficiency of CO2-enhanced oil recovery. Although geophysical monitoring techniques for CO2 sequestration have grown out of conventional oil and gas geophysical exploration techniques, it takes a long time to conduct geophysical monitoring, and there are many barriers and challenges. In this paper, with the initial objective of performing CO2 sequestration, we studied the geophysical tasks associated with evaluating geological storage sites and monitoring CO2 sequestration. Based on our review of the scope of geophysical monitoring techniques and our experience in domestic and international carbon capture and sequestration projects, we analyzed the inherent difficulties and our experiences in geophysical monitoring techniques, especially, with respect to 4D seismic acquisition, processing, and interpretation.
