腹腔镜气腹对机械通气时气管导管套囊压力的影响  

作　　者：吴春娴 高彬[1] 

机构地区：[1]宁波大学医学院附属医院,315211

出　　处：《浙江临床医学》2019年第12期1707-1709,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨腹腔镜二氧化碳气腹对气管导管套囊压力的影响以及套囊压力与气道压力的相关性.方法 选择2018年1至6月择期腹腔镜胆囊手术患者30例(L组),开腹手术患者30例(O组).年龄20~65岁,ASA Ⅰ或Ⅱ级.麻醉诱导并插入钢丝加强型气管导管,使用压力表将套囊内压调整至28cm H2O,每隔10min记录套囊内压、气道峰压,一共记录6次(T0-T5).结果 与T0比较,L组患者T2、T3、T4和T5时间点的套囊压均显著升高(均P<0.001).与T0比较,L组患者T2、T3、T4和T5时间点的气道峰压均显著升高(T4:P<0.01,其余时间点均P<0.001).T2、T3、T4和T5时间点,L组的套囊压和气道峰压均大于O组(套囊压:均P<0.001;气道峰压:T4:P<0.01,其余时间点均P<0.001).Person相关分析结果显示,L组患者套囊压和气道峰压之间存在显著相关性(r=0.956,P=0.003).结论 腹腔镜气腹手术患者气管导管套囊内压显著升高,气道压力的增加是导致气管导管套囊内压升高的重要原因.Objective To investigate the effect of carbon dioxide pneumoperitoneum on endotracheal tube cuff pressure and the correlation between cuff pressure and airway pressure.Methods 30 patients(group L)with elective laparoscopic cholecystectomy and 30 patients(group O)with laparotomy from January to June 2018 were selected.Patients aged 20~65 years old,ASA Ⅰ or Ⅱ.After induction of anesthesia,a wire-reinforced endotracheal tube was inserted,and the pressure inside the casing was adjusted to 28cm H2O with a pressure gauge.The cuff pressure and airway peak pressure were recorded every 1 Ominutes for a total of 6 times(T0-T5).Results Compared with TO,the cuff pressure at the T2,T3,T4 and T5 time points were significantly increased in the group L(all P<0.001).Compared with TO,the peak pressure of airway at T2,T3,T4 and T5 were significantly increased in group L(T4:P<0.01,P<0.001 at other time points).At T2,T3,T4 and T5,the cuff pressure and airway peak pressure of group L were greater than those of group O(cuff pressure:both P<0.001;peak pressure of airway:T4:P<0.01,P<0.001 at other time points).Person correlation analysis showed a significant correlation between cuff pressure and airway peak pressure in group L(r=0.956,P=0.003).Conclusion Endotracheal catheterization pressure is significantly increased in patients undergoing laparoscopic pneumoperitoneum surgery.

关 键 词：气腹 气管导管套囊压 气道峰压 

分 类 号：R47[医药卫生—护理学]