目的:探讨经皮二氧化碳分压(transcutaneous partial pressure of carbon dioxide,PtcCO2)监测在硬质支气管镜下冯氏气管内超声引导纵隔切开活检(Feng's endobronchial ultrasound-guided transbronchial node biopsy,Feng's EBUS-TBNB)中的应用.方法:收集2019年8月-2022年8月期间天津医科大学总医院收治的纵隔疾病患者128例,随机分成 Feng's EBUS-TBNB 组和支气管内超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)组,患者均予高频喷射通气行硬质支气管镜下操作及PtcCO2监测,EBUS-TBNA组患者行EBUS-TBNA,Feng's EBUS-TBNB组患者行Feng's EBUS-TBNB术,比较两组患者术前(T0)、通气开始时(T1)、通气10 min后(T2)、通气20 min 后(T3)、通气 30 min 后(T4)、通气 40 min 后(T5)、通气 50 min 后(T6)、通气 60 min 后(T7)心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)和PtcCO2的变化.结果:T1～T7时,两组患者HR、MAP和PtcCO2水平均明显高于T0时(P＜0.05).T0～T2时,两组患者HR、MAP和PtcCO2水平比较差异无统计学意义(P＞0.05);T3～T5时,Feng's EBUS-TBNB组HR、MAP和PtcCO2水平均明显高于EBUS-TBNA组(P＜0.05);而T6～T7时,两组患者HR、MAP和PtcCO2水平比较差异无统计学意义(P＞0.05).结论:将PtcCO2应用于Feng's EBUS-TBNB中,可间接反映患者HR、MAP水平变化,值得临床推广应用.
Application of transcutaneous carbon dioxide partial pressure monitoring in Feng's EBUS-TBNB under rigid bronchoscope
Objective:To investigate the application of transcutaneous partial pressure of carbon dioxide(PtcCO2)monitoring in Feng's endobronchial ultrasound-guided transbronchial node biopsy(Feng's EBUS-TBNB)under rigid bronchoscope.Meth-ods:A total of 128 patients with mediastinal disease admitted to Tianjin Medical University General Hospital from August 2019 to August 2022 were recruited.Patients were randomly divided into Feng's EBUS-TBNB group and EBUS-TBNA group.All patients were performed with high-frequency jet ventilation and PtcCO2 monitoring during the operation.The heart rate(HR),mean arterial pressure(MAP)and PtcCO2 of all patients were recorded at different time,before ventilation(T0),begin-ning of ventilation(Ti),10 min(T2),20 min(T3),30 min(T4),40 min(T5),50 min(T6)and 60 min(T7)after ventilation,respectively,and were compared between two groups.Results:The HR,MAP and PtcCO2 of patients at T1-T7 in two groups were all higher that of at T0(P＜0.05).The comparisons of HR,MAP and PtcCO2 of patients at T0-T2 between two groups,there were no signifi-cant differences(P＞0.05).The HR,MAP and PtcCO2 of patients at T3-T5 in Feng's EBUS-TBNB group were significantly higher than that of in EBUS-TBNA group(P＜0.01).However,there were no significant differences of HR,MAP and PtcCO2 of patients at T6-T7 between two groups(P＞0.05).Conclusion:The applications of PtcCO2 monitoring in Feng's EBUS-TBNB under RB were safe,and could indirectly detect the HR and MAP of patients,and thus is worthy of clinical application.
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