测压表间断测压致气囊内压力偏差的实验研究

Experimental study on pressure deviation in tube cuff caused by intermittent pressure measurement with gauge

目的不同目标压力下,运用手持测压表间断测量人工气道气囊内压力,分析测量值与实际值偏差大小及规律,为手持测压表正确使用提供参考。方法采用自身配对设计的实验方法,比较传统测压法与改良测压法测量值与实际值偏差大小及规律。传统测压法通过气管插管模型模拟人工气道实验,在不同目标压力30、28、26 cmH_(2)O,分别用手持测压表间断测量气管导管套囊内压力,分别为传统测压1组、传统测压2组和传统测压3组,快速分离测压表和气囊单向阀,然后再次连接测压表与气囊单向阀,得出每组测量值与损失值,每组重复120次。改良测压法在气囊压力30 cmH_(2)O时,在测压表上连接一个医用三通,三通开关调至45°,充气至30 cmH_(2)O后,连接气囊与三通,转动三通使测压表与气囊连接,得出测压值和损失值,重复操作120次,记为改良测压组。结果传统测压1组、传统测压2组、传统测压3组测量值分别为(23.27±0.88)、(21.15±0.83)、(17.63±1.28)cmH_(2)O,三组目标压力与测量值比较,差异有高度统计学意义(P<0.01)。传统测压1组与传统测压2组压力损失值比较,差异无统计学意义(P>0.05);传统测压1组压力损失值小于传统测压3组,差异有统计学意义(P<0.05);传统测压2组压力损失值小于传统测压3组,差异有统计学意义(P<0.05)。改良测压组压力损失值小于传统测压1组,差异有统计学意义(P<0.05);改良测压组测量值为(29.48±0.45)cmH_(2)O,在目标压力范围内。结论传统手持测压表间断测量气囊内压力,压力损失明显;运用改良后三通测量气囊压力的方法可以有效减少压力损失。

Objective Use the handheld gauge to measure the pressure in the cuff of the tracheal tube intermittently,to analyze the deviation of the measure value and the actual value of the cuff pressure in different target,and to provide references for the use.Methods The experiment used self-match design,compared the difference between the measure value and the actual value by the traditional method and the improved method.Traditional manometry simulated artificial airway through the tracheal intubation model.The handheld gauge was used to measure the pressure in the cuff of the tracheal tube intermittently.Under different target pressures 30,28,26 cmH_(2)O,recorded as traditional group 1,traditional group 2 and traditional group 3,the handheld gauge and the air bag were quickly separated,and then connected again to get the measurement value and the loss value,each group was repeated 120 times.Improved manometry while the airbag pressure was 30 cmH_(2)O,connected medical tee to the pressure gauge,adjusted the tee switch to 45°,and after inflated to 30 cmH_(2)O,connected the airbag and the tee,then turn the tee,got the pressure value and the loss value.Results The measurement values of traditional group 1,traditional group 2 and traditional group 3 were(23.27±0.88),(21.15±0.83)and(17.63±1.28)cmH_(2)O,the target pressure and measured value of three groups were compared,the differences were with highly statistically significant(P<0.01).There was no statistically significant of pressure loss value between the traditional group 1 and the traditional group 2(P>0.05).The pressure loss value of the traditional group 1 was lower than that of the traditional group 3,the difference was statistically significant(P<0.05),the pressure loss value of the traditional group 2 was lower than that of the traditional group 3,the difference was statistically significant(P<0.05).The pressure loss value of the improve pressure measuring group was lower than that of the traditional group 1,the difference was statistically significant(P<0.05).The measured value of the improve pressure measuring group was(29.48±0.45)cmH_(2)O,within the target pressure range.Conclusion The pressure loss by traditional manometry is obvious.The improve pressure manometry by tee can effectively reduce the pressure loss.