中国现代医学杂志2016，Vol.26Issue(7)：65-68,4.DOI:10.3969/j.issn.1005-8982.2016.07.015
经食管监测脉搏氧饱和度在开胸手术中的应用研究
Application of trans-esophageal arterial oxygen saturation monitoring in thoracotomy
摘要
Abstract
Objective To observe the sensitivity and accuracy of trans-esophageal monitoring of pulse oxygen saturation (SteO2) in thoracic operation. Methods In 80 patients undergoing selective thoracic operation with general anesthesia and one lung ventilation, a self-made air-bag SteO2 probe was placed in the middle and distal segments of esophagus after induced intubation, the balloon was inflated. According to different pressure on the detection part of the esophageal wall, the patients were randomly divided into group C (pressure of balloon = 0 cm H2O), group S1 (20 cm H2O), group S2 (40 cm H2O) and group S3 (60 cm H2O) with 20 patients in each group. In all the patients minute ventilation was decreased (VT=6 ml/kg, RR=10/min) and 30% oxygen was inhaled. The time of SpO2 and SteO2 decreasing to 95% and 91% was record, and SaO2 was detected at the same time. The number of SteO2 signal interference and complications were recorded. Results SteO2 signals were successfully monitored in all the patients. Compared with the group C (no air-bag inflation), signal interference significantly reduced after air-bag inflation in the groups S1, S2 and S3 ( <0.05). In hypoxic condition, in all the groups the drop of SteO2 was ahead of SpO2 drop. When SteO2 in the group C dropped to 95%, it was most sensitive in warning de-saturation compared with the groups S2 and S3 ( <0.05); at the time when SteO2 in the groups C and S1 dropped to 91%, it was significantly different form that of the groups S2 and S3 ( <0.05). However, SaO2 as the reference standard, the incidence of deviation of SteO2 in the group C significantly increased compared to that in the groups S2 and S3 when SpO2 was 95%( <0.05); it also significantly increased in the groups C and S1 compared to that in the groups S2 and S3 when SpO2 was 91% ( < 0.05). Conclusions SteO2 monitoring could be used as an approach for oxygen saturation monitoring which can give earlier warning of hypoxia. Since different pressure on the surface of esophageal wall has influence on the measured results, for the exclusion of interference by esophageal intramural venous flow, the pressure of air-bag at 40 cm H2O is reasonable when SteO2 value is close to SaO2.关键词
经食管脉搏氧饱和度/全身麻醉/单肺通气Key words
trans-esophageal arterial oxygen saturation/general anesthesia/one-lung ventilation分类
医药卫生引用本文复制引用
杜鑫丹,曲丕盛,万海方,黄丽霞,陶凡..经食管监测脉搏氧饱和度在开胸手术中的应用研究[J].中国现代医学杂志,2016,26(7):65-68,4.基金项目
浙江省杭州市卫计委课题 （）
