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摘要: 目的:比较危重症患者机械通气时气囊实际压力,探讨合理而实用的注气标准。方法:用随机数字表法将120例因呼吸衰竭而建立人工气道行机械通气的患者随机分为手指捏感法组、固定注气法组和囊内压测定法组,每组各40例。用气管套管球囊压力专用测量仪(Endotest仪)对进行机械通气的危重症患者的气管套管、球囊压力进行精确测量。结果:手指捏感法组、固定注气法组和囊内压测定法组囊内压均随着充气时间的延长而降低,差异有统计学意义(均P<0.05)。与同一时间段手指捏感法组、固定注气法组相比,囊内压测定法组囊内压最低(均P<0.05),手指捏感法组、固定注气法组同一时间段囊内压差异无统计学意义(均P>0.05)。三组患者吸痰前后囊内压差异无统计学意义(均P>0.05)。与手指捏感法组、固定注气法组相比,囊内压测定法组不良事件最少,差异有统计学意义(P<0.05)。结论:测定囊内压能更好地起到保护患者的作用,减少并发症。
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[1] BRAZ J R,VOLNEY A,NAVARRO L H,et al.Does sealing endotracheal tube cuff pressure diminish the frequency of postoperative laryngotracheal complaints after nitrous oxide anesthesia[J]?J Clin Anesth,2004,16:320-325.
[2] ISHIKAWA T,SEKIZAWA S,SANT' AMBROGIO F B,et al.Endotracheal cuff pressure as an index of airway smoothmuscle activity:Comparison with total lung resistance[J].Respir Physiol,1998,112:175-184.
[3] SAJEDI P,MAAROFFI V,et al.The macroscopic changes of tracheal mucosa following tight versus lose control of tracheal tube cuff pressure[J].Acta Anaesthesiol Sin,2002,40:117-120.
[4] 王岩,申雪琴,武强.对机械通气患者气管套管气囊压力的临床观察[J].南方护理学报,2004,11(5):40-41.
[5] CHAPMAN J,PALLIN D,FERRARA L,et al.Endotracheal tube cuff pressures in patients intubated before transport[J].Am J Emerg Med,2009,27:980-982.
[6] 陈健.43例机械通气相关性肺炎的临床分析[J].新疆医学,2006,36(1):60-61.
[7] MANDOE H,NIKOLAJSEN L,LINTRUP U,et al.Sore throat after endotracheal intubation[J].Anesth Analg,1992,74:897-900.
[8] 崔晶,段宝民.经口与经鼻气管插管呼吸机相关肺炎发生的比较[J].护士进修杂志,2006,21(9):857-858.
[9] SEEGOBIN R D,VAN HASSELT G L.Endotracheal cuff pressure and tracheal mucosal blood flow:endoscopic study of effects of four large volume cuffs[J].Br Med J (Clin Res Ed),1984,288:965-968.
[10] 魏宏建,付春来,荣令,等.套囊充气方法选择的探讨[J].中国呼吸与危重监护杂志,2006,5(1):25-27.
[11] 李泽葵,邓健祥,杨智学.机械通气病人气管导管的气囊压力与吸气峰压的关系[J].岭南急诊医学杂志,2003,8(2):86-87.
[12] 于政恩.MOV气囊充气法对预防气管气压伤及呼吸机相关肺炎(VAP)的作用[J].中国社区医师,2009,11(216):封三.
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