临床误诊误治2023，Vol.36Issue(8)：56-62,7.DOI:10.3969/j.issn.1002-3429.2023.08.012
二氧化碳调节罩对气管切开术后呼吸性碱中毒患者血气分析及脑氧代谢的影响
Effect of Carbon Dioxide Mask on Blood Gas Analysis and Cerebral Oxy-gen Metabolism in Patients with Respiratory Alkalosis after Tracheotomy
摘要
Abstract
Objective To investigate the effects of carbon dioxide mask on blood gas indexes and cerebral oxygen me-tabolism in patients with respiratory alkalosis after tracheotomy.Methods Fifty patients with respiratory alkalosis after trach-eotomy treated from January 2020 to January 2023 were selected and divided into observation group(n =25)and control group(n =25)according to intervention methods.The observation group used carbon dioxide mask fixed on the face for abdominal breathing,and the control group used traditional paper bag covering the mouth and nose for abdominal breathing.The clinical effect and the time of complete remission of symptoms were compared between the two groups.Blood gas indexes[arterial par-tial pressure of carbon dioxide(PaCO2),base excess extracellular fluid(BEecf),actual bicarbonate(AB),total carbon di-oxide],circulation indexes[mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)],cerebral oxygen me-tabolism indexes[cerebral arterio-venous oxygen content difference(Da-jvO2),cerebral oxygen uptake rate(CERO2)],and oxidative stress indexes[myeloperoxidase(MPO),malondialdehyde(MDA),superoxide dismutase(SOD)]levels before tracheotomy(T1),at 10 min after tracheotomy(T2),at 30 min after tracheotomy(T3),and immediately after operation(T4)were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P＜0.01).The time to complete remission of symptoms in the observation group was(32.27±10.62)min,which was shorter than that in the control group[(154.23±40.16)min](P＜0.01).PaCO2,BEecf,AB,total carbon dioxide and SOD in the two groups were significantly lower at T2 than at T1,and higher at T3-T4 than at T2,which were lower at T3-T4 than at T1 in the control group,and higher at T3-T4 in the observation group than in the control group(P＜0.05).MAP,HR,RR,Da-jvO2,CERO2,MPO and MDA in the two groups were significantly higher at T2 than at T1,and lower at T3-T4 than at T2,which were higher at T3-T4 than at T1 in control group,but lower at T3-T4 in the ob-servation group than in the control group(P＜0.05).Conclusion The use of carbon dioxide mask in patients with respirato-ry alkalosis after tracheotomy can improve the clinical effect,accelerate the improvement of clinical symptoms,promote more stable blood gas circulation,correct the abnormal state of cerebral oxygen metabolism,and help alleviate the oxidative stress injury of the body.关键词
气管切开术/碱中毒,呼吸性/二氧化碳调节罩/二氧化碳分压/平均动脉压/脑氧摄取率/丙二醛/超氧化物歧化酶Key words
Tracheotomy/Alkalosis,respiratory/Carbon dioxide mask/Partial pressure of carbon dioxide/Mean ar-terial pressure/Cerebral oxygen uptake rate/Malondialdehyde/Superoxide dismutase分类
临床医学引用本文复制引用
梁保平,刘凯文..二氧化碳调节罩对气管切开术后呼吸性碱中毒患者血气分析及脑氧代谢的影响[J].临床误诊误治,2023,36(8):56-62,7.基金项目
吕梁市科技重点研发项目(2018shfz64-7) （2018shfz64-7）
