Page 82 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第44卷第6期
·818 · Journal of Nanjing Medical University（Natural Sciences） 2024年6月

·临床研究·

经皮二氧化碳测量在腹膜后腹腔镜泌尿外科手术中的准确性：

一项前瞻性观察性研究

孔秋月 ，刘 洋 ，李 楠 ，黄少康 ，杨 春 ，刘存明 ，丁正年 ，王 娴 ，刘世江 1，4*
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南京医科大学第一附属医院麻醉与围术期医学科，江苏 南京 210029；上海中医药大学附属市中医医院麻醉科，上海
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200071；南京医科大学附属妇产医院（南京市妇幼保健院）麻醉科，江苏 南京 210004；江苏省人民医院重庆医院（重庆市
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綦江区人民医院）麻醉科，重庆 401420
［摘 要］ 目的：比较呼气末二氧化碳分压（end⁃tidal carbon dioxide partial pressure，PETCO2）和经皮二氧化碳分压（transcutane⁃
ous carbon dioxide partial pressure，PTCCO2）预测泌尿外科腹膜后腹腔镜手术患者动脉血二氧化碳分压（arterial carbon dioxide
pressure，PaCO2）的准确性。方法：选择全身麻醉下行腹膜后腹腔镜泌尿外科手术患者50例，于气腹前及气腹后30、60、90 min
分别测定PaCO2、PETCO2、PTCCO2。计算PaCO2⁃PETCO2和PaCO2⁃PTCCO2的差值。对PaCO2与PETCO2、PaCO2与PTCCO2进行相关性和回
归分析。采用Bland⁃Altman 分析评价PaCO2与其他两个指标的一致性。结果：PaCO2⁃PETCO2和PaCO2⁃PTCCO2的绝对差值分别为
（13.20±4.43）mmHg和（4.35±2.56）mmHg（P < 0.05）。PaCO2与PETCO2的相关系数为0.79（r =0.62，P < 0.001），与PTCCO2的相关系
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数为 0.91（r =0.83，P < 0.001）。PaCO2与 PETCO2的 95%一致性界限为 4.53~21.88 mmHg，与 PTCCO2的 95%一致性界限为-3.18~
10.48 mmHg。结论：PTCCO2监测可提高评估患者腹膜后腹腔镜泌尿外科手术中PaCO2的准确性。
［关键词］ 经皮二氧化碳；腹膜后腹腔镜；泌尿外科手术；血气监测；呼气末二氧化碳
［中图分类号］ R614 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）06⁃818⁃08
doi：10.7655/NYDXBNSN231201

The accuracy of transcutaneous carbon dioxide measurement in retroperitoneoscopic
urologic surgery：a prospective observational study

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KONG Qiuyue ，LIU Yang ，LI Nan ，HUANG Shaokang ，YANG Chun ，LIU Cunming ，DING Zhengnian ，WANG
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Xian ，LIU Shijiang 1，4*
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Department of Anesthesiology and Perioperative Medicine，the First Affiliated Hospital of Nanjing Medical University，
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Nanjing 210029；Department of Anesthesiology，Shanghai Municipal Hospital of Traditional Chinese Medicine，
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Shanghai 200071；Department of Anesthesiology，Women’s Hospital of Nanjing Medical University（Nanjing
Maternity and Child Health Care Hospital），Nanjing 210004；Department of Anesthesiology，Chongqing Hospital of
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Jiangsu Province Hospital（the People’s Hospital of Qijiang District），Chongqing 401420，China
［Abstract］ Objective：To compare the accuracy of end⁃tidal carbon dioxide partial pressure（PETCO2）and transcutaneous carbon
dioxide partial pressure（PTCCO2）in predicting arterial carbon dioxide pressure（PaCO2）in patients undergoing retroperitoneoscopic
urologic surgery. Methods：Fifty patients undergoing retroperitoneoscopic urologic surgery under general anesthesia were included.
Values of PaCO2，PETCO2，and PTCCO2 were measured before and 30，60，90 min after insufflation. The differences between P aCO2⁃PETCO2
and PaCO2⁃PTCCO2 were calculated. Correlation and regression analysis were conducted between P aCO2 and PETCO2，as well as between
PaCO2 and PTCCO2. Bland⁃Altman analysis was used to assess the agreement between P aCO2 and the other two variables. Results：The
absolute differences of P aCO2⁃PETCO2 and PaCO2⁃PTCCO2 were（13.20 ± 4.43）mmHg and（4.35 ± 2.56）mmHg，respectively（P < 0.05）.
The correlation coefficient between P aCO2 and PETCO2 was 0.79（r =0.62，P < 0.001），and between PaCO2 and PTCCO2 was 0.91（r =0.83，
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P < 0.001）. The 95% limits of agreement between P aCO2 and PETCO2 were 4.53 to 21.88 mmHg and between PaCO2 and PTCCO2 were -
［基金项目］ 国家自然科学基金（82002023）；江苏省自然科学基金（BK20201087）
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通信作者（Corresponding author），E⁃mail：liushijiang@njmu.edu.cn