摘要
目的通过对三种套囊充气方法的效果比较，总结出理想的套囊充气方法。方法应用Portex专用套囊测压计，对44例入住重症监护室（ICU）气管插管或气管切开行机械通气的病人分别实施手指捏感法、固定注气法和最小容积阻塞法充气，于充气末测定套囊内压力。结果入ICU首次套囊压力为（52．40±8．08）cmH2O。手指捏感法、固定注气法和最小容积阻塞法的套囊内压力分别为（53．27±7．00）cmH2O、（62．00±8．24）cmH2O和（12．41±2．29）cmH2O，最小容积阻塞法与前两种方法充气后其套囊内压相比有显著性差异（P〈0．01）。在气道峰压为30cmH2O时前两种方法病人气道无漏气情况，最小容积阻塞法则有4例出现少许气道漏气。结论采用套囊压力计监测套囊内压力是一种科学、理想的方法。手指捏感法和固定注气法均不尽理想，而最小容积阻塞法其套囊内压力稍低于正常。在没有压力计时，可在最小容积阻塞法充气的基础上，再注气0．5～1mL为宜．
Objective To compare three methods of inflating endotracheal tube cuff with manometer so as to prevent ischemic damages of tracheal mucosa due to the overdistension of cuff. Methods 44 patients were enrolled who were either intubated with endotracheal tubes or had tracheostomies and were given mechanical ventilation. The endotracheal tube cuff pressure（CP） was measured by the PORTEX manometer immediately after they were delivered into the intensive care unit（ CP1 ）. Then the CP were measured after three methods of the cuff inflating respectively（ CP2, CP3, CP4）. Method A： the inflation of cuff was stopped by checking the handbag＇s pressure according to doctor＇s experience. Method B： Infused a fixed volume of 10 mL air. Method C： Inflated the cuff till air leakage just disappeared judged by using a stethoscope. Results CP1 was（52.40 ±8.08）cm H2O. CP2, CP3 and CP4 were （53.27 ± 7.00） cm H2O, （62.00 ± 8.24） cm H2O, （ 12.41 ± 2.29）cm H2O respectively. Tbere was significant difference between CP2 and CP4（ P 〈 0.01）, CP3 and CP4 either. When the peak airway pressure was as high as 30 cm H2O, there were 4 cases with little air leakage in group of method C, but no air leakage in group of method A and B. Conclusions To monitor CP by using the Portex manometer is proved valuable, Method A and B are not reliable to prevent excessive cuff pressure. Method C may have a little air leakage, and infusion of 0.5 - 1 mL air added is worthy of recommendation if no manometer is available.
出处
《中国呼吸与危重监护杂志》
CAS
2006年第1期25-27,共3页
Chinese Journal of Respiratory and Critical Care Medicine
基金
美国健康教育基金PSBH资助(04PSBH21)
关键词
套囊压力
测定
Cuff pressure
Measurement
