吸入气与呼气末氧浓度差和呼气末二氧化碳在全麻急性低通气时的变化规律_临床医学论文.docVIP

吸入气与呼气末氧浓度差和呼气末二氧化碳在全麻急性低通气时的变化规律_临床医学论文 吸入气与呼气末氧浓度差和呼气末二氧化碳在全麻急性低通气时的变化规律_临床医学论文 作者：韩柏秀 黄科昌 王秀莹 于天英 【关键词】 全身麻醉 　　【摘要】 目的 观察N 2 O-O 2 静吸复合全麻时急性低通气恢复正常后I-EO 2 和ETCO 2 变化规律的比较。 方法 20例N 2 O-O 2 静吸复合全麻患者，术中机械通气，FiO 2 =0.35。观察由正常V T （10ml/kg）调至4ml/kg后15min和迅速调回至正常后15min内各指标的变化。 结果 低通气后I-EO 2 、ETCO 2 、BP和HR均明显增加。恢复正常通气后HR、BP和ETCO 2 于15min内先后恢复正常，而I-EO 2 仍高出低通气前的17.2%。而且，各观察时点I-EO 2 的变化率均高于ETCO 2 的变化率（0.01）。 结论 与ETCO 2 相比，I-EO 2 虽能更早地反映通气量降低，但却不能及时反映通气量的恢复。 　　关键词 全身麻醉 通气 吸入气与呼气末氧浓度差 呼气末二氧化碳 　　Changes of inspiratory to end-tidal oxygen concentration difference and end-tidal carbon dioxide during acute hypoventilation 　　Han Boxiu，Huang Kechang，Wang Xiuying，et al. 　　Affiliated Hospital of Weifang Medical College，Weifang261031. 　　【Abstract】 Objective To compare the regulation of the changes of inspiratory to end-tidal oxygen concen-tration difference（I-EO 2 ）and end-tidal carbon dioxide（ETCO 2 ）after the correction of acute hypoventilation during intravenous inhalation anesthesia.Methods Twenty patients underwent N 2 O-O 2 intravenous inhalation anesthesia were received volume-controlled mechanical ventilation with an FiO 2 =0.35.After a period of normal ventilation with V T =10ml/kg，acute hypoventilation was induced with V T =4ml/kg for15minutes followed by an correction with nor-mal ventilation.I-EO 2 ，ETCO 2 ，BP，HR and SpO 2 were observed for15minutes for each process.Results During the period of hypoventilation，there were significant increases for BP and HR，especially for I-EO 2 and ETCO 2 .Fifteen minutes after the correction of hypoventilation，HR，BP and ETCO 2 recovered to normal level，while I-EO 2 were still higher than that prior to acute hypoventilation.Morever，the changes of I-EO 2 were much higher than those of ETCO 2 at all these measurements.Conclusion In comparison with ETCO 2 ，I-EO 2 will reflex the decrease of ventilation ear-lier，but not the recovery of ventilation. 　　Key words general anesthesia ventilation inspiratory to end-tidal oxygen concentr