人工气道套囊压力调整频率的临床研究

Clinical research of the frequency adjust of artificial airway cuff pressure

目的探讨并评价人工气道套囊压力的调整频率,为临床护理提供依据。方法临床护理中每日交接班时(8∶00、16∶00和22∶30),先记录平静状态下的人工气道套囊压力,并再将气囊压力调整至30cmH2O。体外模拟实验:用50ml注射器模拟气道,将气管插管插入其中并调整套囊压力为30cmH2O,静置每4h测量套囊压力。观察比较每日交接班时人工气道套囊压力。结果临床工作中如果每日3次调整套囊压力,调整前的套囊压力仍然维持在25～30cmH2O的仅为36.7%,60.2%的套囊压力低于25cmH2O,最低值为8cmH2O;高于30cmH2O的有3.1%,其最高达50cmH2O。体外模拟实验中,95.1%的套囊压力都能维持在25～30cmH2O,仅4.9%低于25cmH2O,最低值为22cmH2O。结论静置的套囊压力基本维持在预期的范围,但临床按照指南建议的每日3次监测套囊压力,并不能将套囊压力维持在指南建议的25～30cmH2O。建议临床护理工作中增加调整套囊压力次数,以减少因气囊压力降低而导致的危害。

Objective To monitor and compare the artificial airway cuff pressure during daily shift changes,and to evaluate the adjusting of the frequency of the artificial airway cuff pressure.Method The artificial airway cuff pressure was noted under tranquility 3times every day（8：00,16：00和22：30）,then readjust the pressure to 30 cmH2O,to simulate vitro experiment：artificial airway cuff was laid in 50ml injector,pressure was adjusted to 30 cmH2O,the pressure was measured after 4hours standing.Result The study showed that monitoring the tracheal cuff pressure 3times every day,only 36.7%cases maintain 25～30cm H2O,60.2%cases lower than 25cmH2O,3.1%cases was higher than 30cmH2O,the maximum is 50cmH2O,the minimum is 8cmH2O.for simulated vitro experiment,95.1%cases maintain 25～30cmH2O,only 4.9% cases lower than 25cmH2O,the minimum is 22 cmH2O.Conclusion The improved monitor can maintain the tracheal cuff pressure in ideal area（25～30cmH2O）,but normal monitor can not attain the goal.It’s suggested that clinical nursing added the frequency of adjusting the end tracheal tube cuff pressure to devoid the damage.