呼气末二氧化碳监测的临床应用

Clinical Application of End-Tidal Carbon Di-oxide Monitoring

摘要: 呼气末二氧化碳分压(P_ETCO₂)是指呼吸末呼出气中二氧化碳浓度，呼气末二氧化碳监测是一种无创监测手段。对于呼吸和循环功能监测最直接的方法是进行动脉血气分析，该法为有创操作、不能连续测定且费用较高昂，与血气分析相比P_ETCO₂可以无创、实时、连续监测患者呼吸与循环功能，美国麻醉医师协会(ASA))早已规定P_ETCO₂为麻醉期间的基本监察观测项目。现将从P_ETCO₂监测的基本原理以及测定方法、P_ETCO₂影响因素、P_ETCO₂临床应用(包括气管导管位置确定、循环功能监测、肺栓塞等的辅助诊断)三大方面阐述P_ETCO₂的临床应用进展，为一线医生们在评估病人病情时提供帮助。

Abstract: End-tidal carbon dioxide partial pressure (P_ETCO₂) refers to the concentration of carbon dioxide in the exhaled breath at the end of respiration. End-tidal carbon dioxide monitoring is a non-invasive monitoring method. The most direct method for monitoring respiratory and circulatory function is to perform arterial blood gas analysis. This method is invasive, cannot be measured continuously and is expensive. Compared with blood gas analysis, P_ETCO₂ can monitor the patient’s respiratory and circulatory functions non-invasively, in real time, and continuously. The American Association of Anesthesiologists (ASA) has long established P_ETCO₂ as a basic monitoring and observation item during anesthesia. This paper expounds the progress of clinical application of P_ETCO₂ from three aspects: the basic principle and determination method of P_ETCO₂ monitoring, the influencing factors of P_ETCO₂, and the clinical application of P_ETCO₂ (including the location of endotracheal tube, monitoring of circulatory function, auxiliary diagnosis of pulmonary embolism, etc.), so as to provide help for front-line doctors in evaluating the condition of patients.

文章引用：杨敏, 赵集, 刘闵, 李炬颖, 袁清霞. 呼气末二氧化碳监测的临床应用[J]. 医学诊断, 2020, 10(3): 177-182. https://doi.org/10.12677/MD.2020.103029

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