气囊漏气实验预测严重上气道狭窄的临床意义

The Clinical Significance of Cuff leak Test to Identify Severe Upper Airway Stenosis

目的:观察气囊漏气实验预测拔管后发生严重上气道梗阻的临床价值。方法:共有156例气管插管患者入组,根据气囊漏气实验的情况分为两组,阴性组和阳性组,拔除气管插管后观察两组喘鸣发生与二次气管插管情况。结果:156例患者中气囊漏气实验阴性组125例,阳性组31例,拔除气管插管后,有13例患者需再次插管,其中1例患者无法插管,予经皮气管切开。结论:气囊漏气实验是一项简单方便筛查拔管后可能上气道梗阻的方法,如为阴性其因严重上气道梗阻再插管可能性很小,如为阳性则要注意可能发生拔管后上气道梗阻。

Objective： To observe the value of cuff leak test to predict the severe airway obstruction after extubation. Methods： A total of 156 patients with tracheal intubation were enrolled. According to cuff leak test, they were divided into negative group and posi- tive group. We observed the occurrences of stridor and reintubation after extubation. Results： There were 125 cases in the negative group and 31 cases in the positive group. After extubation, 13 patients required reintubation, including 1 case of percutaneous tracheostomy be- cause of failure to endotracheal reintubate. Conclusion： The cuff leak test is a simple and useful tool to screen the occurrences of airway obstruction after extubation. The possibility of severe airway obstruction is very small in negative group. We must pay attention to the positive group because of the high rate of reintubation.