不同气囊漏气实验方法预测高危气管插管患者发生喉头水肿的比较被引量：5

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摘要目的比较两种气囊漏气实验方法预测高危气管插管患者发生喉头水肿的准确性,为判断拔管时机提供依据。方法将进入ICU需要气管插管机械通气超48 h的80例患者,根据气囊漏气实验的方法分为A组(n=40)和B组(n=40),A组是通过观察呼吸囊正压通气时抽出气囊气体,部分气体漏出时是否在咽喉部发出气流声音,医务人员凭借临床经验粗略判断出气体泄漏量;B组是通过充、松气囊期间呼吸机监测呼出潮气量的数据变化,具体计算出漏气量。分析两组患者气囊漏气实验的结果,比较拔除气管插管后发生喉头水肿及再插管情况。结果 A、B组阳性率分别为17.5%、15.0%,组间比较差异无统计学意义(P>0.05)。A组再次插管发生率为20.0%,较B组的5.0%明显升高,差异有统计学意义(2=4.114,P<0.05)。结论对于气管插管患者,气囊漏气实验是一项简便的预测拔管后可能发生喉头水肿的方法,而定量气囊漏气实验方法精确计算漏气量,更能准确地判断拔管时机,明显提高了患者拔管的安全性。

作者冼燕珊周立新莫韶妹温伟标曾添辉

机构地区广东省佛山市第一人民医院重症医学科

出处《广东医学》 CAS 北大核心 2015年第13期2117-2119,共3页 Guangdong Medical Journal

关键词气囊漏气实验定性法定量法预测喉头水肿

分类号 R563.8 [医药卫生—呼吸系统]

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参考文献9

1ANTONAGLIA V, VERGOLINI A, PASEOTrO S, et al. Cuff- leak test prediets the severity of postextubation acute laryngeal le- sions: a preliminary study[ J]. Eur J Anaesthesiol, 2010, 27 (6) : 534 -541.
2MAURY E, GUGLIELMINOTYI J, AI.ZIEU M, et al. How to identify patients with no risk for postextubation stridor? [ J ]. J Crit Care, 2004, 19(1) : 23 -28.
3ZHOU T, ZHANG H P, CHEN W W, et al. Cuff- leak test for predicting postextubation airway complications: a systematic review [J]. JEvidBasedMed, 2011,4(4): 242 -254.
4HAYAMI H, NAGAI S, OHAMA S, et al. A cuff-leak pressure test is a simple method for assessing severe laryngeal edema in posto- perative patients [ J ]. Crit Care, 2010, 14 ( Suppl 1 ) : 230 - 234.
5刘颖,葛秋生,周于新.布地奈德雾化吸入治疗新生儿气管插管后喉头水肿的临床观察[J].中国基层医药,2011,18(10):1325-1326. 被引量：8
6隋峰.外科ICU患者气囊漏气试验预测拔管后严重上气道梗阻的临床意义[J].临床和实验医学杂志,2011,10(20):1594-1596. 被引量：15
7ADDERLEY R J, MULLINS G C. When to extubate the croup pa- tient: the "leak" test[J]. Can J Anaesth, 1987, 34(3) : 304 -306.
8ANTONAGLIA V, VERGOLINI A, PASCOTTO S, et al. Cuff- leak test predicts the severity of postextubation acute laryngeal le- sions : a preliminary study [ J ]. Eur J Anaesthesiol, 2010, 27 (6) : 534 -541.
9WITTEKAMP B H, VAN MOOK W N, YJAN D H, et al. Clini- cal review: post - extubation laryngeal edema and extujbation fai- lure in critically ill adult patints[J]. Crit Care, 2009, 13 (6) : 233 - 235.

二级参考文献17

1李瑶,刘洁.布地奈德混悬液雾化吸入治疗急性喉炎的疗效观察[J].儿科药学杂志,2007,13(3):48-49. 被引量：13
2Zielnik-Jurkiewicz B.Glucocorticosteroids in the treatment of subglottic laryngitis in children.Otolaryngol Pol,2005,59(4):553-557.
3Szefler SJ,Lyzell E,Fitzpatrick S,et al.Safety profile of budesonide inhalation suspension in the pediatric population:worldwide experience.Ann Allergy Asthma Immunol,2004,93(1):83-90.
4Song IH,Buttgereit F.Non-genomic glucocorticoid effects to provide the basis for new drug developments.Mol Cell Endocrinol,2006,246(1-2):142-146.
5Powell CE,Watson CS,Gametchu B.Immunoaffinity isolation of native membrane glucoeorticoid receptor from S-49++lymphoma cells:biochemical characterization and interaction with Hsp 70 and Hsp 90.Endocrine,1999,10(3):271-280.
6Horvath G,Wanner A.Inhaled corticostemids:effects on the airway vaseulature in bronchial asthma.Eur Respir J,2006,27(1):172-187.
7Mendes ES,Pereira A,Danta I,et al.Comparative bronchial vasoconstrictive efficacy of inhaled glucocortieosteroids.Eur Respir J.2003,21(6):989-993.
8Jónsson B,Eriksson M,Soder O,et al.Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease Acla Paediatr,2000,89(12):1449-1455.
9Maury E,Guglielminotti J,Alzieu M,et al.How to identify patients with no risk for postextubation stridor[J]? J Crit Care,2004,19(1):23-28.
10De Bast Y,De Backer D,Moraine JJ,et al.The cuff leak test to predict failure of tracheal extubation for laryngeal edema[J].Intensive Care Med,2002,28(9):1267-1272.