摘要
目的 探讨连续呼气末二氧化碳（PETCO2）监测在儿童监护室（PICU）危症患儿行纤维支气管镜术中的应用价值。方法 收集2011年5月-2012年3月该院PICU在三通喉罩连续通气下未连接呼气末CO2监护仪进行纤维支气管镜术的87例呼吸系统疾病重症患儿为对照组;2012年4月-2013年5月该院PICU在三通喉罩连续通气下连接呼气末CO2监护仪进行纤维支气管镜术的108例呼吸系统疾病的重症患儿为治疗组。观察两组患儿的无创血压、心率和经皮血氧饱和度变化;治疗组术中连续监测呼气末二氧化碳（PET-CO2）,通过调整呼吸频率维持PETCO2在35～60 mmHg。结果 ①治疗组纤维支气管镜操作成功率（89.8%）,明显高于对照组（78.2%）。②对照组2次以上纤支镜操作率为31.0%,治疗组2次以上纤支镜操作率为21.3%,差异无显著性。③对照组纤维支气管镜术持续时间为（12.6±7.8）min,明显长于治疗组（9.8±8.3）min。④术后患儿清醒时间比较：对照组（21±7.2）min较治疗组明显延长（17±8.4）min。结论 连续呼气末CO2监测在危重患儿进行三通喉罩连续性通气下纤维支气管镜术中具有重要的应用价值,值得临床推广使用。
【Objective】To evaluate the value of continuous monitoring of exhaled CO2 in severe children with fiberoptic bronchoscopy.【Methods】Eighty-seven children with respiratory diseases from May 2011 to March 2012 in PICU received bronchoscopy in three-way laryngeal mask（TLMA） open airway without monitoring of exhaled CO2 as control group. One hundred and eight children selected as the treatment group from April 2012 to May 2013 in the same ward received bronchoscopy in three-way laryngeal mask open airway with monitoring of exhaled CO2. The changes of children＇s noninvasive blood pressure, heart rate, pulse oxygen saturation（SPO2） and end-tidal carbon dioxide tension（PETCO2） were monitored in the treatment group, PETCO2 was maintained between 35~60 mm Hg by adjusting the respiratory rate. 【Results】1Treatment group bronchoscopy success rate（89.8%） was significantly higher than control group（78.2%）. 2There was no statistical difference of bronchoscopy operations with more than 2times between the control group（31.0%） and the treatment group（21.3%）. 3There were significantly differences in the treatment group compared with the control group on the fiber bronchoscopy operating time（12.6 ±7.8） min vs（9.8±8.3） min. 4In the control group（21±7.2） min was significantly longer in children with postoperative recovery time（17±8.4） min compared with the treatment group. 【Conclusion】Continuous monitoring of exhaled CO2 in severe children with fiberoptic bronchoscopy in TLMA open airway is of importance, worthy of clinical application.
出处
《中国内镜杂志》
北大核心
2015年第3期284-286,共3页
China Journal of Endoscopy
基金
河南省2012年科技发展计划(No:122102310123)
