指触结合压力表测压在人工气道气囊压力维护中的应用

Control of endotracheal cuff pressures using finger estimation and manometer measurement

目的探讨人工气道气囊压力测定与维护的有效方法。方法将100例气管插管机械通气患者随机分为对照组46例和观察组54例。对照组采用单纯气囊测压表测压,每8小时测量1次;观察组采用指触测压与气囊测压表相结合的测压方法:培训5名护士掌握指触测压方法,在每晨8:00气囊测压表测压的基础上,每4小时指触测压1次。结果观察组患者气囊压力维持在理想水平(20～30cmH2O)显著高于对照组,并发症及漏气发生率显著低于对照组(P<0.05,P<0.01);观察组护士测压依从性显著高于对照组(P<0.01)。结论采用专用测压表与指触测压法相结合对人工气道气囊进行压力测定,安全有效,提高了测压依从性,降低了并发症发生率。

Objective To explore an effective method for measurement and control of endotracheal cuff pressure （Pcuff）. Methods One hundred consecutive mechanically ventilated patients were randomized to a control group （n=46） and an observation group （n=54）. Initial target Pcuff （20-30 cmH2O） of both groups was set with a manometer, and then Pcuff of the control group was monitored and adjusted with a manometer according to current recommendations （three times a day）. For the observation group, after initial measurement with manometers, Pcuff was additionally monitored by using finger estimation： 5 nurses were trained to master measurement of Pcuff with finger estimation and were asked to adjust Pcuff every 4 hours with this method. Results Compared with the control group, the ratio of Pcuff be tween 20 and 30 cmH20 in the observation group was significantly higher, and incidence rates of complications and cuff leakage were signi- ficantly reduced （P〈0.05 ,P〈0.01） ; Nurses＇ adherence to monitoring of Pcuff in the observation group was significantly increased （P〈 0.01）. Conclusion Monitoring of Pcuff with finger estimation and manometer measurement is safe and effective, which can improve nurses＇ compliance with measurement and reduce incidence of complications.