经皮二氧化碳测量在腹膜后腹腔镜泌尿外科手术中的准确性:一项前瞻性观察性研究OA北大核心CSTPCD
The accuracy of transcutaneous carbon dioxide measurement in retroperitoneoscopic urologic surgery:a prospective observational study
目的:比较呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,PETCO2)和经皮二氧化碳分压(transcutane-ous carbon dioxide partial pressure,PTCCO2)预测泌尿外科腹膜后腹腔镜手术患者动脉血二氧化碳分压(arterial carbon dioxide pressure,PaCO2)的准确性.方法:选择全身麻醉下行腹膜后腹腔镜泌尿外科手术患者50例,于气腹前及气腹后30、60、90min分别测定 PaCO2、PETCO2、PTCCO2.计算 PaCO2-PETCO2 和 PaCO2-PTCCO2的差值.对 PaCO2与 PETCO2、PaCO2与 PTCCO2进行相关性和回归分析.采用Bland-Altman分析评价PaCO2与其他两个指标的一致性.结果:PaCO2-PETCO2和PaCO2-PTCCO2的绝对差值分别为(13.20±4.43)mmHg和(4.35±2.56)mmHg(P＜0.05).PaCO2与 PETCO2的相关系数为0.79(r2=0.62,P＜0.001),与 PTCCO2的相关系数为 0.91(r2=0.83,P＜0.001).PaCO2与 PETCO2的95％一致性界限为 4.53～21.88 mmHg,与 PTCCO2的95％一致性界限为-3.18～10.48 mmHg.结论:PTCCO2监测可提高评估患者腹膜后腹腔镜泌尿外科手术中PaCO2的准确性.
Objective:To compare the accuracy of end-tidal carbon dioxide partial pressure(PETCO2)and transcutaneous carbon dioxide partial pressure(PTCCO2)in predicting arterial carbon dioxide pressure(PaCO2)in patients undergoing retroperitoneoscopic urologic surgery.Methods:Fifty patients undergoing retroperitoneoscopic urologic surgery under general anesthesia were included.Values of PaCO2,PETCO2,and PTCCO2 were measured before and 30,60,90 min after insufflation.The differences between PaCO2-PETCO2 and PaCO2-PTCCO2 were calculated.Correlation and regression analysis were conducted between PaCO2 and PETCO2,as well as between PaCO2 and PTCCO2.Bland-Altman analysis was used to assess the agreement between PaCO2 and the other two variables.Results:The absolute differences of PaCO2-PETCO2 and PaCO2-PTCCO2were(13.20±4.43)mmHg and(4.35±2.56)mmHg,respectively(P＜0.05).The correlation coefficient between PaCO2 and PETCO2 was 0.79(r2=0.62,P＜0.001),and between PaCO2 and PTCCO2 was 0.91(r2=0.83,P＜0.001).The 95％limits of agreement between PaCO2and PETCO2 were 4.53 to 21.88 mmHg and between PaCO2and PTCCO2 were-3.18 to 10.48 mmHg.Conclusion:PTCCO2 monitoring improves the accuracy of estimating PaCO2 in patients undergoing retroperitoneoscopic urologic surgery.
孔秋月;刘洋;李楠;黄少康;杨春;刘存明;丁正年;王娴;刘世江
南京医科大学第一附属医院麻醉与围术期医学科,江苏 南京 210029上海中医药大学附属市中医医院麻醉科,上海 200071南京医科大学附属妇产医院(南京市妇幼保健院)麻醉科,江苏 南京 210004南京医科大学第一附属医院麻醉与围术期医学科,江苏 南京 210029||江苏省人民医院重庆医院(重庆市綦江区人民医院)麻醉科,重庆 401420
临床医学
经皮二氧化碳腹膜后腹腔镜泌尿外科手术血气监测呼气末二氧化碳
transcutaneous carbon dioxideretroperitoneoscopicurologic surgeryblood gas monitoringend-tidal carbon dioxide
《南京医科大学学报（自然科学版）》 2024 (006)
818-825 / 8
国家自然科学基金(82002023);江苏省自然科学基金(BK20201087)
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