摘要
目的研究经后腹腔镜下泌尿外科手术中用经皮二氧化碳分压(PTCCO2)监测评估PaCO2的准确性和相关性。方法择期行后腹腔镜下泌尿外科手术的ASAⅠ或Ⅱ级患者,在气腹前和气腹后30、60min分别测量PaCO2、PETCO2和PTCCO2。计算PaCO2-PETCO2和PaCO2-PTCCO2的差值,数据分析采用Bland-Altman分析。结果 30例患者最终被纳入研究,共获得76个数据。PaCO2-PETCO2为(13.3±3.9)mmHg,PaCO2-PTCCO2为(5.2±2.4)mmHg。PaCO2与PETCO2之间的相关系数r为0.743(P<0.01),线性回归方程为PETCO2=0.42×PaCO2+17.25,r2为0.55(P<0.01);PaCO2与PTCCO2之间的相关系数r为0.900(P<0.01),线性回归方程为PTCCO2=0.95×PaCO2-2.39,r2为0.81(P<0.01)。PaCO2-PETCO2差值和PaCO2-PTCCO2差值的均数的95%的一致性界限(LOA)分别为(13.3±7.8)mmHg和(5.2±4.8)mmHg。结论在后腹腔镜下泌尿外科手术中,PTCCO2比PETCO2能更准确地估计PaCO2,由于个体间差异,PTCCO2监测仍不能替代动脉血气分析。
Objective To investigate the accuracy and correlation of estimating PaCO2 using a transcutaneous CO2 pressure（PTCCO2 ） monitor in patients undergoing retroperitoneoscopic renal or adrenal surgery. Methods Patients who were ASA I or II undergoing retroperitoneoscopie renal or adrenal surgery were included in this study. Their PaCO2, PETCO2 and PTCCO2 values were measured at 30 min before and 30 min, 60 min after pneumoperitoneum and calculated the different between each measure（PETCO2 and PTCCO2 ） and PaCO2. Agreement among measures was assessed hy the Bland-Altman method. Results Thirty adults were studied and seventy six sample sets were obtained. The average PaCO2 -- PTCCO2 difference was （5.2 ± 2.4） mm Hg （mean-- SD）. The correlation coefficient（r） of PaCO2 and PETCO2 was 0. 743 and the coefficient of deter mination（re ） was 0.55. The correlation coefficient（r） of PaCO2 and PETCO2 was 0. 900 and the coefficient of deter mination （r2） was 0. 81. The average PaCO2 --PETCO2 difference was （13.3±3.9） mm Hg （mean±SD）. 95% of .the limits of agreement of the average PaCO2 -PETCO2 difference was （13.3±7.8） mm Hg, 95% of the limits of agreement of the average PaCO2 --PTCCO2 difference was （5.2±4. 8） mm Hg （meani 1.96SD）. Conclusion While undergoing retroperitoneoscopic renal or adrenal surgery, transcutaneous carbon dioxide monitoring provides a better estimate of PaCO2 than PETCO2 but cannot be substituted for PaCO2 analyses in these patients.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第6期576-579,共4页
Journal of Clinical Anesthesiology
