人工气道不同气囊压对气道损伤及误吸的影响

Influence of different ballonet pressures of artificial airway on airway injury and aspiration

目的:气囊压力在气道管理中有重要的意义,过低可致吸入性肺炎的发生率升高,过高可损伤气道黏膜。本研究旨在探讨不同气囊压力对人工气道的影响。方法:选取我院ICU建立人工气道行机械通气患者96例,随机分为A组、B组和C组,采用POTEX专用气囊压力表观察气囊内压分别为35cmH2O、30cmH2O、25cmH2O,于插管后72h行纤维支气管镜、胸片及细菌培养检查。结果:A组气道损伤9例,B组5例,C组1例;A组误吸2例,B组1例,C组8例。结论:人工气道应采取合适气囊压,25～30cmH2O为最适范围。对人工气道患者采用专用套囊测压仪指导套囊注气量及控制囊内压,以最大限度避免气道黏膜的损伤及误吸的发生。

Objective： Ballonet pressure plays an important role in the management of artificial airway. Too low ballonet pressure would lead to increasing incidence of pneumonia while excessive ballonet pressure will hurt airway mucosa. This study aims to explore the influence of different ballonet pressures on artificial airway. Methods ：96 patients with artificial airway and artificial ventilation in the ICU of the hospital were chosen and randomly divided into three groups with ballonet pressures of 35 cmH2O ,30 cmH2O and 25 cmH2O （Group A, B and C）, respectively, which were observed by POTEX ballonet pressure meter. Brenehofiberseopo examinations and X - ray chest examinations would be performed after 72 h of trachea intubation within the 3 groups. Resuits ：There were 9 cases, 5 cases and 1 case of airway injury in group A, B and C, respectively and there were 2 eases, 4 cases and 8 cases of pulmonary infection in group A, B and C, respectively. Conclusion： The appropriate ballonet pressure should be chosen for artificial airway, and the most suitable hallonet pressure range is 25 -30 cmH2O. Professional ballonet pressure meter should be adopted to test and control the pressure in ballonet to minimize the incidence of airway injury and aspiration to the full extent.