慢性阻塞性肺病患者人工气道气囊压力监测及护理

Pressure monitoring of COPD patients accepted artificial airway gasbag and the nursing

目的探讨人工气道气囊压力监测在慢性阻塞性肺病(下称慢阻肺)患者气管插管气囊压力监测中的应用价值。方法将60例人工气道的慢阻肺患者随机分为两组。实验组采用专用的PORTEX气囊测压表注气测量压力,对照组采用传统的手估气囊测压注气,用呼吸机监测漏气情况;比较两组患者气囊压力、气囊容积和并发症的发生率。结果实验组气囊压力为(27.50±2.50)cm H2O,气囊容积为(11.0±1.8)mL,呼吸机监测不漏气。对照组气囊压力为(42.74±7.26)cm H2O,气囊容积为(15.0±5.2)mL,呼吸机监测不漏气。实验组发生气管黏膜损伤、气囊破裂的例数明显少于对照组,差异有统计学意义(P<0.05),两组发生误吸、气管食管瘘和气囊漏气的例数经比较差异均无统计学意义(P>0.05)。结论慢阻肺患者人工气道气囊压力采用专用的气囊测压表注气测量压力并将压力维持在(27.50±2.50)cm H2O,能有效避免气管黏膜损伤、气囊破裂、气囊漏气和误吸的发生。

Objective To probe into the application value of pressure monitoring of artificial airway gasbag in nursing care of chronic obstructive pulmonary disease （COPD） patients accepted tracheal catheterization. Methods 60 COPD patients with artificial airway were randomly divided into two groups. Patients of test group were used with inflation of special air pressure gauge PORTEX aero cyst pressure monitoring meter to acetify and take pressure, while patients in control group were applied traditional fingers-nipping to acetify. Air leakage of the two groups was checked via ventilator. Both aero cyst pressure,aero cyst volume and complication incidence were compared with each other. Resu.lts When aero cyst pressure of test group was（27.50 ± 2.50） cm H2 O, aero cyst volume was （ 11.0±1. 8）mL. However,when aero cyst pressure of control group was（42.74±7.26）cm H20,air bag volume was（15.0±5. 2）mE. No air leakage was monitored in two groups. There were less brachial mucous injury or aero cyst broken in test group than control group, with significant difference （P〈0.05）. There was no obvious difference between two groups in aspiration,esophago-tracheat fistula and air leakage（P〉0.05）. Conclusion The gasbag pressure of COPD patients with artificial airway is measured with inflation of special air pressure gauge and maintain （29.50±2.50）cm H2O, which effectively avoids airway mueosa injury, aero cyst broken, air leakage and aspiration.