摘要
探讨呼气末二氧化碳分压(PetCO2)动态监测对全麻老年患者腹腔镜肝脏切除术后麻醉苏醒质量与安全的影响,为麻醉苏醒安全提供参考。选择2017年2月~2019年11月我院行全麻下腹腔镜肝脏切除术患者80例,40例术后常规监测生命体征为对照组、40例常规加用PetCO2监测为观察组,观察组22例65~74岁患者作为低龄组、18例75~85岁患者作为高龄组。获取患者进入复苏室1、15、30、45 min常规生命体征(BP、HR、SPO2)、PetCO2监测指标[PetCO2、动脉血二氧化碳分压(PaCO2)、PetCO2和PaCO2差值]、苏醒质量指标(PetCO2异常率、苏醒时间、麻醉复苏室停留时间、苏醒期并发症发生率),Pearson相关分析PetCO2、PaCO2相关性。2组BP、HR、SPO2组间、组内比较均无显著差异(P>0.05);观察组进入复苏室1、15、30、45 min时刻PetCO2、PaCO2呈递减趋势(P<0.05),PetCO2、PaCO2差值无显著差异(P>0.05)。高龄组进入复苏室1、15、30、45 min时刻PetCO2异常率均高于低龄组(P<0.05)。观察组苏醒时间、麻醉复苏室停留时间、苏醒期并发症发生率低于对照组(P<0.05)。腹腔镜肝脏切除术全麻后老年患者麻醉苏醒期动态监测PetCO2可了解机体生命体征变化,及时发现、处理并发症,有利于提高苏醒质量和保证恢复期安全管理。
The aim of this study is to investigate the postoperative anesthesia recovery and safety analysis of elderly patients with laparoscopic hepatectomy under general anesthesia monitored by end-tidal carbon dioxide partial pressure(PetCO2),so as to provide basis for anesthetic safety.80 elderly patients with laparoscopic hepatectomy under general anesthesia in our hospital from February 2017 to November 2019 were enrolled,and divided into two groups,each with 40 cases.The control group received routine monitoring,while observation group was monitored by PetCO2.The observation group was further divided into two groups according to their ages,old group(65~74 years old,n=22)and older group(75~85 years old,n=18).Various indexes were recorded,including vital signs(BP,HR,SPO2),PetCO2 monitoring indicators[PetCO2,arterial blood carbon dioxide partial pressure(PaCO2),PetCO2-PaCO2 difference],and recovery quality(PetCO2 abnormality rate,wake-up time,residence time in recovery room,complication rate during wake-up period).Then correlation between PetCO2 and PaCO2was verified by Pearson analysis.Comparison of BP,HR and SPO2 within and between groups showed no significant difference(P>0.05).There was a decreasing trend in PetCO2 and PaCO2with the increase of residence time in recovery room(P<0.05),while no significant difference was found in PetCO2-PaCO2 difference(P>0.05).PetCO2 of the older group was lower than that of the old group at each time points in recovery room(P<0.05).The wake-up time,residence time in recovery room,and complication rate during wake-up period in observation group were all better than those of the control group(P<0.05).PetCO2monitor for elderly patients with laparoscopic hepatectomy under general anesthesia can effectively monitor the vital signs and complications,thus improving the recovery quality and safety.
作者
胡静
李元海
HU Jing;LI Yuan-hai(Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China)
出处
《广西大学学报（自然科学版）》
CAS
北大核心
2020年第4期853-859,共7页
Journal of Guangxi University（Natural Science Edition）
基金
国家自然科学基金资助项目(61505224)。
关键词
血气监测
经皮
麻醉恢复期
老年人
blood gas monitoring
transcutaneous
anesthesia recovery period
aged
