摘要
目的观察分析呼气末二氧化碳分压(PetCO_2)在急诊儿科危重症救治中的应用价值。方法选取本院2015年1月至2017年2月收治的需紧急行气管插管、机械通气的84例危重症患儿,根据患儿在急诊的转归情况进行分组,分别分配到存活组(61例)与死亡组(23例)。回顾性分析所选患儿的临床资料,在人工通气或机械通气0.5、1、6、12及24 h后,采取患儿安静或睡眠状态下动脉血进行血气分析,并记录即刻PetCO_2,计算出动脉血二氧化碳分压(PaCO_2)与PetCO_2的差(Pa-etCO2)。结果机械通气后0.5、1、6、12及24 h,患儿PetCO_2与PaCO_2均呈正相关(P均<0.05);Pa-et CO2与通气时间呈负相关(P<0.05)。机械通气后1 h,存活组患儿PetCO_2与PaCO_2呈正相关(P<0.01),死亡组患儿PetCO_2与PaCO_2呈正相关(P<0.01);存活组与死亡组患儿Pa-et CO2分别为(2.16±5.34)mm Hg、(7.81±8.19)mm Hg,死亡组患儿明显高于存活组(P<0.05)。结论在多数情况下,急诊儿科危重症救治中应用PetCO_2可以监测出PaCO_2的动态变化,具有无创性、简便性、连续性等优点,可有效减轻患儿的痛苦,提高急诊抢救效率,但由于机体通气状态及外界多种因素的影响,在必要时需要联合血气分析进行对照,结合进行危重患儿病情变化的评估。
Objective To investigate the application value of PetCO2for critical disease rescue in pediatric emergency. Methods Eighty-four sick children with critical disease in our hospital from January 2015 to February 2017 needed trachea cannula and mechanical ventilation were selected. The sick children were divided into survival group （n = 61 ） and death group （n = 23 ）. Clinic data were retrospectively analyzed. After artificial ventilation or mechanical ventilation of 0. 5,1,6,12 and 24 h , arterial blood of the patients were adopted under quiet or sleep state for blood gas analysis. The immediate PetCO2was recorded and the difference （ Pa-etCO2 ） between P, CO2 and PetCO2was calculated. Results At the 0. 5,1,6,12 and 24 h after mechanical ventilation, PetCO2 and PaCO2 were positively correlated （P 〈 0.05） ,and Pa-etCO2and ventilation time were negatively correlated （P 〈 0.05）. Atthe 1 h after mechanical ventilation, PetCO2 and PaCO2were positively correlated in the beth groups （P 〈 0. 01 ）. Pa-etCO2in the survival group was 2. 16±5.34 mmHg that was significantly lower than that in the death group （7.81±8.19 mmHg,P 〈 0. 05）. Conclusion In most cases,PetCO2is used to monitor dynamic change of PaCO2in pediatric emergency. It is noninvasive, simple and continuous. It can relieve pain of children and improve emergency rescue efficiency. However, because of body vented condition and a variety of factors, blood gas analysis is needed for comparison to evaluate changes of the illness.
出处
《实用医院临床杂志》
2017年第6期143-145,共3页
Practical Journal of Clinical Medicine
基金
四川省卫生厅科研基金资助项目(编号:120509)
