延长呼气法和冷静呼气法etco2在慢性壅塞性肺疾病中的比拟.docVIP

延长呼气法和平静呼气法呼气末二氧化碳监测在慢性阻塞性肺疾病中的比较 作者：李德容 郑则广 林佩仪 张秀燕 谢灿茂 陈荣昌 钟南山????作者单位：广州医学院第一附属医院广州呼吸疾病研究所， 广东 广州 510120　 广州医学院第二附属医院麻醉科， 广东 广州 510260　 广州医学院附属广州市第二人民医院麻醉科， 广东 广州 510150　 中山大学第一附属医院呼吸科， 广东 广州 510080 【摘要】? 目的：在23例COPD病人中（合并Ⅱ型呼吸衰竭者15例），分别采用平静呼气法和延长呼气法测定PETCO2，探讨两种方法测定PETCO2与PaCO2的关系。方法：采用红外线吸收法，以主气流方式测定慢性阻塞性肺疾病（COPD）病人平静呼气PETCO2［PETCO2(T)］和延长呼气5s时的PETCO2 ［PETCO2(P)］，同步检测PaCO2。随访治疗后PaCO2与PETCO2的变化。结果：平静呼气时PETCO2为50.93±13.35mmHg(6.79±1.78Kpa),PaCO2为59.10±15.53mmHg(7.88±2.07kPa)，两者比较有显著差异（P0.05）；延长呼气5s时PETCO2为58.95±14.70（7.86±1.96Kpa），和PaCO2比较无显著差异（P0.05）。平静呼气及延长呼气PETCO2变异系数分别为5.01±3.09%和5.00±2.58%，两者无显著差异（P0.05）。治疗后PETCO2的变化可反映的PaCO2变化。结论：COPD病人中，延长呼气法测定PETCO2 可预测PaCO2和反映其动态变化，可用于无创监测COPD患者的PaCO2动态变化，具有重要的临床应用价值。 【关键词】? 呼出气 慢性阻塞性肺疾病 二氧化碳 　　Comparing Study of Prolonged Expriation Method and Expiration Method in the Measurement of Expired Gas PCO2 at end Expiration in COPD Patients 　　LI De-rong,? ZHENG Ze-guang,? et al 　　(The First Affiliated Hospital of Guangdong Medical College,Guangdong Guangzhou 510120, China) 　　Abstract： Objective: In order to investigate the possibility of estimating the arterial PCO2 (PaCO2) with the measurement of expired gas PCO2 at end expiration using the prolonged expiration method, end expiration PCO2 (PETCO2) was measured with tidal (PETCO2(T)) and prolonged expiration method (PETCO2(P)) in COPD patients. Method: 23 severe COPD patients admitted into the hospital because of acute exacerbation were recruited for the study. Expired PCO2 was measured with NOVAMETRIC CO2 monitoring system（Novametric Co, USA）. PETCO2 was measured with tidal breathing PETCO2(T) and prolonged expiration (more than 5 seconds) methods PETCO2(P), and PaCO2 was measured simultaneously.? The relationship between PaCO2, PETCO2(T) and PETCO2(P) was analyzed. Follow-up measurements were repeated 7~8 days later in order to evaluate the relationship between the change in PaCO2, and PETCO2(P). Result：The PETCO2 was dynamically related to the expiratory time (Fig. 1) in