吸入气及呼气末氧浓度差及呼气末二氧化碳在全麻急性低通气时变.docVIP

吸入气及呼气末氧浓度差及呼气末二氧化碳在全麻急性低通气时变 　　　　　　　　　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（Plt;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 concentration difference end-tidal carbon dioxi