CAJ | 학술논문

目的：在肺移植术中，比较上腔静脉血与混合静脉血血氧饱和度，为麻醉中选择监测方法提供参考。方法：接受肺移植手术的患者30例，分别置入中心静脉导管于上腔静脉、漂浮导管于肺动脉。在置管后（T1）、第一侧病肺切除前（T2）、第一侧供肺开放后（T3）、第二侧病肺切除前（T4）、第二侧供肺开放后（T5）以及手术结束前（T6）同时抽取上腔静脉血和肺动脉血行血气分析。比较上腔静脉血与混合静脉血血气分析中血氧饱和度。结果：T1～T6，上腔静脉血SpO2与混合静脉血SpO2 Bland-Altman一致性检验：均数差值依次为0．9、3．4、2．3、0．5、0．27和－2．9，超上下限范围发生率为3．3％、0％、0％、3．3％、3．3％和0％，位于Bland-Altman一致性界限内的百分率为96．7％、100％、100％、96．7％、96．7％和100％。结论：在肺移植手术过程中，上腔静脉血SpO2可以作为混合静脉血SpO2的近似参考。
목적：재폐이식술중，비교상강정맥혈여혼합정맥혈혈양포화도，위마취중선택감측방법제공삼고。방법：접수폐이식수술적환자30례，분별치입중심정맥도관우상강정맥、표부도관우폐동맥。재치관후（T1）、제일측병폐절제전（T2）、제일측공폐개방후（T3）、제이측병폐절제전（T4）、제이측공폐개방후（T5）이급수술결속전（T6）동시추취상강정맥혈화폐동맥혈행혈기분석。비교상강정맥혈여혼합정맥혈혈기분석중혈양포화도。결과：T1～T6，상강정맥혈SpO2여혼합정맥혈SpO2 Bland-Altman일치성검험：균수차치의차위0．9、3．4、2．3、0．5、0．27화－2．9，초상하한범위발생솔위3．3％、0％、0％、3．3％、3．3％화0％，위우Bland-Altman일치성계한내적백분솔위96．7％、100％、100％、96．7％、96．7％화100％。결론：재폐이식수술과정중，상강정맥혈SpO2가이작위혼합정맥혈SpO2적근사삼고。
Objective To compare the oxygen saturation between the blood of superior vena cava and mixed venous in lung transplantation and provide reference for monitoring method in anesthesia. Methods 30 patients who received lung transplantation were placed central venous catheter into superior vena cava and flotation catheter into the pulmonary artery in turn. The blood samples were collected from the superior vena cava and pulmonary artery for blood gas analysis simultaneously at the time of just followed the catheter placement (T1), before the resection of the first bad lung (T2), after the reperfusion of the first donor lung (T3), before the resection of the second bad lung (T4), after the reperfusion of the second donor lung (T5), before the end of the operation (T6). The oxygen saturation were compared between the blood of the superior vena cava and mixed venous. Results From T1 to T6, Bland-Altman analysis showed that the mean of deviation between the SpO2 measured in blood of superior vena cava and mixed venous were 0.5, 3.4, 2.3, 0.5, 0.27,-2.9, respectively, and the incidence beyond the upper and lowed limits of consistency zone was 3.3%, 0%, 0%, 3.3%, 3.3%, 0%respectively. The incidence of SpO2 within the consistent limits was 96.7%, 100%, 100%, 96.7%, 96.7%, 100% respectively. Conclusions The SpO2 of superior vena cava may be approximately reference as SpO2 of mixed venous during lung transplantation.