一次性可调节输液器输注准确性及其影响因素的评估

Evaluation of the adjustable infusion flow regulator's accuracy and the affected factors

目的评价DOSI-FLOW3可调节输液器输注的准确性及其影响因素。方法将30套可调节输液器均分为6组:生理盐水组、复方乳酸钠组、5%葡萄糖组、10%葡萄糖组、万汶组及血定安组。室温20℃下,可调节输液器理论标示流速均设置为100ml/h,观察时间均为1h,记录下列4种情况下输液器的实际流量。①不同液体种类的影响:选择上述6组液体,每组5套,悬挂高度(液面距量杯底部距离)80cm,输液器前端不接针头,测1h流量。②不同悬挂高度的影响:增加上述6组液体悬挂高度至160cm,输液器前端不接针头,测1h流量。③不同型号针头的影响:选择24G、22G双翼式套管针及23G头皮针,接于输液器前端,悬挂高度均为80cm,测1h流量。④静水压力的影响:将连接上述3种型号针头输液器置入预先盛20cm高度生理盐水的量杯底部,悬挂高度均为80cm,测1h流量。结果①液体种类的影响:万汶组及血定安组流量明显低于其他4组及标示流量(P<0.001),其余4组流量与标示流量接近。②悬挂高度加倍后,各组流量也加倍,万汶组及血定安组流量接近于标示流量,但其他4组流量明显高于标示值(P<0.001)。③使用23G头皮针的实际流速显著低于24G、22G双翼式套管针(P<0.01)。④静水压为20cm水柱组复方乳酸钠及血定安流速显著低于静水压为0组(P<0.001)。结论不同液体种类、悬挂高度、静脉穿刺针型号及静脉压力对可调节输液器的实际流速均可产生明显影响;临床上应结合其他监测手段对患者的容量状况进行正确判断。

Objectives To evaluate the DOSI-FLOW3＇s accurary and to identify factors that may affect the accu-racy.Methods Thirty sets infusion flow regulators （DOSI-FLOW3） were equally divided into six groups：group saline, group ringer, 5% glucose group, 10% glucose group, group voluven and group gelofusine.The real flow volumes were measured during the 1h observation period.The infusion was carried out at room temperature（20℃） in the following 4 situations.①Effect of different liquids.We measured the volumes of the 6 groups （5 in each） respectively with the sus-pensing height being 80cm （no needle attached in the front of the regulator）.②Effect of different suspensing height：the suspensing height was then changed to 160 cm and recorded the volume of each group.③Effect of puncture needle size：3 types of different puncture needle （24G, 22G trocar and 23G scalp needle） attached in the front of the regulator with the suspensing height being 80cm, the volume of each group in 1h was recorded.④Effect of static water pressure：put the regulators with needle attached into containers pre-filled saline of 20 cm height from the bottom, and recorded the volumes of each group in 1h.Results ①1 h flow volumes of the 2 colloids （voluven and gelofusine） were significantly lower than other 4 groups and the volume read on the regulator （P0.001）, the volumes of crystal and glucose groups were similar and approximate to the read of the regulator.②1h flow volumes of the crystal and glucose groups doubled in response to the doubled suspending height （80 cm vs 160 cm）.③ The volume of group with size 23G scalp needle attached was markedly lower than those of the groups with 24G and 22G trocar （P0.01）.④Volume of group at 20 cmH2O static water pressure was significantly lower than that at 0 cmH2O group.Conclusions Liquid category, suspending height, puncture needle size and static water pressure all can evidently affect on the flow rate of DOSI-FLOW3 regulator.In practice, in stead of depending on the read on the regulator only, combined with other clinical signs is important to make a sound judgment about the volume state of the patient.