国内麻醉科医师应用二氧化碳吸收剂的现状调查

Investigation on the current situation of the application of carbon dioxide absorbent by anesthesiologists in China

摘要:

目的 调查国内麻醉科医师应用二氧化碳（CO₂）吸收剂的现状，为统一CO₂吸收剂更换的指标、限值和流程提供参考。
方法 采用自主设计调查问卷开展网络问卷调查，主要内容包括麻醉科医师的基本情况、对CO₂吸收剂应用理论的理解和CO₂吸收剂临床应用的现状。
结果 本次调查发放并回收有效问卷475份，其中49.9%来自华南地区，其他地区的麻醉科医师占50.1%。在对CO₂吸收剂应用理论的理解方面，被调查者最常使用的CO₂吸收剂种类为钠石灰，6.3%的被调查者尚不清楚所在机构使用的CO₂吸收剂种类；13.5%的被调查者能选出全部影响CO₂吸收剂吸收效率的理论因素；分别有79.8%、66.7%和44.8%的被调查者认为CO₂吸收剂“缺乏统一的更换标准和流程”、“环境污染”和“更换操作复杂”应得到关注。在CO₂吸收剂临床应用的现状方面，更换频率与麻醉科医师所在医院的等级显著相关（P<0.05）；更换标准主要依赖FiCO₂和CO₂吸收剂变色量；96.4%的被调查者选择整罐更换，仍有23.8%的被调查者错误地在手术室内更换CO₂吸收剂，有粉尘吸入经历的被调查者高达73.7%。
结论 目前国内麻醉科医师对CO₂吸收剂的应用理论和安全性认识不足，对CO₂吸收剂的更换缺乏统一标准、更换流程欠规范，建议对各级麻醉科医师开展针对性专题培训，并应进一步探索安全高效的CO₂吸收剂更换标准化流程。

Abstract:

Objective To investigate the current situation of perioperative application of carbon dioxide absorbents in China and provide data suppuration and decision-making basis for further exploration of the thresholds of carbon dioxide absorbents.
Methods Self-designed questionnaire was used to carry out network questionnaire survey. The main contents included basic information of anesthesiologists, understanding of the application theory of carbon dioxide absorbents and the status quo of its clinical application.
Results There were 475 anesthesiologists included in this survey, of which 49.9% were from South China, and 50.1% from other regions. The type of carbon dioxide absorbents most commonly used by the anesthesiologists surveyed was soda lime, but 6.3% of the respondents were not clear about the carbon dioxide absorbents used in their institution. Only 13.5% of the surveyed anesthesiologists could correctly select the theoretical factors that affect the carbon dioxide absorbents absorption efficiency. The concerns of anesthesiologists about the application of carbon dioxide absorbents mainly focused on “lack of uniform replacement standards and procedures” (79.8%), “environmental pollution” (66.7%) and “complex replacement operations” (48.8%). In current status of carbon dioxide absorbents replacement by anesthesiologists in this survey, the frequency of carbon dioxide absorbents replacement was significantly related to the grade of the anesthesiologist's hospital (P < 0.05). The main criteria for carbon dioxide absorbents replacement were FiCO2 and the amount of carbon dioxide absorbents discoloration. 96.4% of the anesthesiologists surveyed would choose to replace the carbon dioxide absorbents in the whole tank, 23.8% of the anesthesiologists still replaced the carbon dioxide absorbents in the operating room mistakenly, and 73.7% of the anesthesiologists had dust inhaled during the replacement of carbon dioxide absorbents.
Conclusion Domestic anesthesiologists have insufficient understanding of the application theory and safety of carbon dioxide absorbents, and lack of unified standards for the replacement of carbon dioxide absorbents. It is suggested to carry out special training for anesthesiologists, and explore the safer, more efficient and cost-effective carbon dioxide absorbents replacement standard and guideline in future.