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目的:评价Pn ETCOn 2判断孕产妇脊椎-硬膜外麻醉后仰卧位低血压综合征(SHS)的准确性。n 方法:拟在脊椎-硬膜外麻醉下行择期剖宫产术孕产妇50例，足月妊娠，年龄25～40岁，体重65～90 kg，ASA分级Ⅰ级或Ⅱ级。放置鼻氧管，一孔用于吸氧，吸入氧浓度29%，氧流量2 L/min；一孔用于采样，连接Pn ETCOn 2监测仪，连续监测Pn ETCOn 2。平静仰卧位5 min后，记录SBP及Pn ETCOn 2作为基础值(SBPn 0和Pn ETCOn 2-0)。麻醉给药后每隔1 min记录1次SBP及Pn ETCOn 2，共记录10 min。发生SHS(SBP≤80 mmHg或下降幅度≥30 mmHg)时，静脉注射麻黄碱5～10 mg。按照是否发生SHS分为2组：SHS组和非SHS组。记录麻醉后10 min内SBP最低值(SBPn min)及Pn ETCOn 2最低值Pn ETCOn 2-min。SHS组记录给药即刻至SBP开始升高的时间(Tn SBP)和给药即刻至Pn ETCOn 2开始升高的时间(Tn PETCO2)。计算麻醉前后Pn ETCOn 2的变化率(△Pn ETCOn 2)和SBP的变化率(△SBP)。△Pn ETCOn 2和△SBP行Pearson相关分析；采用受试者工作特征曲线分析Pn ETCOn 2判断SHS的准确性，计算曲线下面积及其95%可信区间。n 结果:与非SHS组比较，SBPn min和Pn ETCOn 2-min降低(n P<0.05)。△Pn ETCOn 2与△SBP呈正相关(n r＝0.745，n P<0.05)。Pn ETCOn 2判断SHS的曲线下面积及其95%可信区间为0.910(0.821～0.998)，临界值为-16.433%，灵敏度为92%，特异度为88%。与Tn SBP比较，Tn PETCO2缩短(n P<0.05)。n 结论:Pn ETCOn 2可准确判断孕产妇脊椎-硬膜外麻醉后SHS。n “,”Objective:To evaluate the accuracy of end-tidal carbon dioxide pressure (Pn ETCOn 2) in diagnosing supine hypotensive syndrome(SHS)after combined spinal-epidural anesthesia in puerpera.n Methods:A total of 50 patients who were at full term, aged 25-40 yr, weighing 65-90 kg, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing elective cesarean section under combined spinal-epidural anesthesia, were enrolled in this study.A nasal oxygen tube was placed, one hole was used for oxygen inhalation, the inhaled oxygen concentration was 29%, and the oxygen flow was 2 L/min; one hole was used for sampling and connected to a Pn ETCOn 2 monitor, and Pn ETCOn 2 was continuously monitored.SBP and Pn ETCOn 2 were recorded as the baseline values (SBPn 0 and Pn ETCOn 2-0) after 5 min of staying calm in the supine position.SBP and Pn ETCOn 2 were recorded every 1 min after administration for anesthesia, a total of 10 min.When SHS (SBP ≤ 80 mmHg or a decrease ≥ 30 mmHg) occurred, ephedrine 5-10 mg was intravenously administered.Puerpera were divided into SHS group and non-SHS group according to whether SHS occurred.The lowest value of SBP (SBPn min) and Pn ETCOn 2 (Pn ETCOn 2-min) within 10 min after anesthesia was recorded.The time from administration to the start of increase in SBP (Tn SBP) and time from administration to the start of increase in Pn ETCOn 2 (Tn PETCO2) were recorded.The rate of change in Pn ETCOn 2 (△Pn ETCOn 2 ) and in SBP (△SBP) before and after anesthesia were calculated.The correlation between △Pn ETCOn 2 and △SBP was tested using Pearson correlation analysis.The receiver operating characteristic curve was used to analyze the accuracy of Pn ETCOn 2 in diagnosing SHS, and the area under the curve and 95% confidence interval were calculated.n Results:Compared with non-SHS group, SBPn min and Pn ETCOn 2-min were significantly decreased in SHS group (n P<0.05). △Pn ETCOn 2 was positively correlated with △SBP (n r=0.745, n P<0.05). The area under the curve of Pn ETCOn 2 in diagnosing SHS and 95% confidence interval were 0.910 (0.821-0.998), and the critical value of △Pn ETCOn 2 was -16.4332% with a sensitivity of 92% and specificity of 88%.Tn PETCO2 was significantly shorter than Tn SBP (n P<0.05).n Conclusion:Pn ETCOn 2 can accurately diagnose SHS after combined spinal-epidural anesthesia in puerpera.n