一种机械通气患者床旁快速筛查气管食管瘘的简易方法

A simple method for bedside rapid screening of tracheoesophageal fistula in the patients with mechanical ventilation

目的探讨检测胃腔内气体浓度对机械通气患者气管食管瘘的诊断价值。方法对机械辅助通气状态的患者,选用容量控制模式,给予100%氧,通气15~20 min后,抽出胃内气体10~50 m L,进行氧浓度检测,胃内气体氧浓度大于30%即为阳性结果。结果 2017年6月~2020年3月我院疑似气管食管瘘的14例患者进行胃内气体检测,胃内气体氧浓度最低32%,最高71%,均经食管镜或气管镜检查确诊。结论对机械通气状态的怀疑气管食管瘘的危重患者,胃内气体检测氧浓度法可作为一项安全、快捷、可靠的筛查方法。

Objective To explore the diagnostic value of the measurement of intragastric oxygen concentration in the tracheoesophageal fistula of the patients with mechanical ventilation. Methods For the patients with mechanical ventilation,the volume controlled ventilation mode was selected with the supply of 100% oxygen,about 10-50 m L gas was extracted from the stomach and oxygen concentration was measured 15-20 minutes after ventilation. Gastric oxygen concentration more than 25% was the positive result. Results 14 suspected patients of tracheoesophageal fistula underwent gastric gas measurement. The lowest concentration of oxygen in the stomach was 32%,and the highest was 71%.All the patients were finally diagnosed by esophagoscope and tracheoscope. Conclusion For suspected critically patients of tracheoesophageal fistula with mechanical ventilation, the method of oxygen concentration in gastric gas can be used as a safe,fast and reliable screening tool.