机械通气患者两种气管导管气囊压力管理方法的临床研究  

Clinical study of two techniques of endotracheal tube cuff pressure management in patients undergoing mechanical ventilation

作　　者：骆月琴[1] 刘春妮[1] 周明[1] 杨文龙[1] 

机构地区：[1]北海市人民医院重症医学科,536000

出　　处：《国际呼吸杂志》2014年第9期674-676,共3页International Journal of Respiration

摘　　要：目的通过比较机械通气患者容量-时间曲线指导的气囊充气法（以下简称容量-时间曲线法）与最小闭合容量（minimalocclusivevolume，MOV）法的气囊充气量及气囊压力，探讨两种气囊压力管理方法的优劣。方法80例患者纳入研究。在相同的机械通气模式、参数条件下，每例患者在研究开始时完全消气囊，在先后用MOV法及容量-时间曲线法重新充气直至完全闭合气道。两次气囊充气间相隔20min，分别记录并比较两者方法的气囊充气量及压力值。结果容量一时间曲线法的气囊充气量及气囊压力明显小于MOV法（PdO．01），12．5％（10／80）患者用MOV法充气后从容量-时间曲线观察仍存在漏气。结论容量一时间曲线指导的气管导管气囊法较MOV法精确、客观，是一种更可靠的指导气囊压力管理的方法。Objective To compare the volume-time curve technique and minimal occlusive volume （MOV） technique by evaluating and comparing the cuff pressure（CP） levels and air volume required to fill the endotracheal tubes cuff using the 2 different techniques in the patients undergoing mechanical ventilation. Methods A total of 80 subjects were analyzed. At the start of the study, the cuff was completely deflated and reinflated, and at this point the volume of air to fill the cuff was adjusted successively using the two techniques： volume-time curve and MOV. The two techniques were separated by 20 minutes. We measured the volume of air injected into the cuff,the CP after the application of each technique. Results The volume-time curve technique demonstrated a significantly lower CP and a lower volume of air injected into the cuff,compared to the MOV technique （ P d0.01）. When the subjects were submitted to the MOV technique, 12.50/00 （ n = 10） experienced air leakage as observed by the volume time graph. Conclusions The volume-time curve technique was more precise and objective than the MOV technique. Therefore,the volume-time curve may be a more reliable alternative for endotracheal tube cuff management.

关 键 词：容量-时间曲线法 最小闭合容量法 气管导管气囊 充气 机械通气 

分 类 号：R459.7[医药卫生—急诊医学]