压力-容量波形法在气囊压力管理中的应用.pdfVIP

Tianjin Joumal of Nursing, August 2015, Vol. 23 No. 4 .283. ·论著· 压力-容量波形法在气囊压力管理中的应用* 陈文丽李晓冬贯提琳霍伟强李茵 (天津市第三中心医院，天津 3∞170) 摘要目的:评价压力-容量波形法(P-V 波形法)用于管理气管插管患者气囊压力的临床效果。方法:选取经口气管插管接呼吸机辅 助呼吸的患者 180 例。采用髓机数字表法随机分为 P-V 波形法组、指感法组和气囊测压表法组，每组各 60 例。比较三组患者在气囊 压力控制水平、撒机后 1 小时及 24 小时并发症(声音嘶哑、咽喉疼痛、咳嗽)的差异。结果 :P-V 波形法组与气囊测压表法组在控制 气囊压力以及撒机后并发症方面结果差异元显著俭，与指惑法组比校能有效控制气囊压力，撤机后并发症明显减少。结论 :P-v 波 形法能控制气囊压力在合理范围，减少气管插管患者撒机后并发症的发生，是一种简单有效的气囊压力管理方法。 关键词:压力一容量波形:气囊压力:气囊管理。 中圈分类号 R47 文献标志码 A DOI: 10.3969/j.issn.H脱-9143.2015.04.∞1 文章编号1c刷-9143(2015)04-0283-03 Application of pressure-volume wave in management of cuff pressure CHEN Wen-li, U Xiao-dong, GUAN Xiao-lin, HUO Wei-qiang, U Yin (The Third Central Hospital of Tianjin, Tianjin 3∞170) A恼tract Objedive: To evaluate the clinical effect of pressure-volume wave (P-V wave) on m皿吨;ement of cuff pressu陀 in patients wi由 tracb回1 intuhation. Metb创15: 180 patients brea由ing with ventilator were randomly divided into P-V wave group, finger feeling group and cufI manometer group according to 出e random number table. each group h田 60c剧目. The capability of 由e control for the cuff pressure and the complications in 1 hour and in 24 hour after removing 由e ventilator we而 compared 田nong 也e thr目 groups. R倒J1ts: 四ere were no statistical differences in 由e 幽严cts of pre困ure control and the complications after removing the ventilator between P-V wave group 皿d cuff manometer group. But the ca附 of P-V group had better capability for pressure control and lower incidences of complication than 由at of finger feeling group. Conclusion: P - V wave method can rnake the range of cuff pressure reasonable, and reduce the incidence of complications in the patients wi曲曲e tr田heal intubation after removing the ventilator. It is a simple and effective method for the management of cuff pressure. Key wonls P四ssure-volume wave; CufI pressure; CufI mar瞌gement 气管插管气囊作用是封闭气道，保证潮气量的供给，固定插 管，防止误吸。气囊压力维持在适当范围能封闭气道，减少气管 插管相关并发症的发生。气囊内压力过低不能有效封闭气道和 进行有效正压机械通气，同时误吸增加，导致呼吸机相关肺炎 (VAP)发生