采用听诊法和传统方法确定气管插管套囊压力的临床观察

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1、采用听诊法和传统方法确定气管插管套囊压力的临床观察黎安良1高鸿2林少峰1龙娟1(1贵州医科大学贵州贵阳550000)(2贵州医科大学附属医院贵州贵阳550000)【摘要】目的：评价听诊法确定气管导管套囊压力的效果。方法:120名择期全麻手术患者，ASA1-11级，性别不限，气管插管后随机分M组和T组，每组60例。M组采用经验法给气管套囊注气，T组采用听诊法给套囊注气，然后两组均用压力换能器测定套囊压力，确定无漏气后机械通气静吸复合麻醉下完成手术。术后24h对患者进行访视，记录患者咽痛、咳嗽、咳痰、声音嘶

2、哑及血丝痰情况。结果：M组套囊压力明显高于T组(P<0.05),M组患者术后咽痛、咳痰、声音嘶哑发生率明显高于T组(PV0.05)。结论：听诊法确定气管导管套囊压力可在合适的套囊压力下封闭气道，乂能明显减少插管后气道并发症，值得临床推广。【关键词】听诊法；气管导管；套囊；压力【中图分类号】R44【文献标识码】A【文章编号】2095-1752(2016)14-0176-02TheClinicalobservationistodetermineoftheoptimumpressreaboutendotrac

3、healcathetercuffbyauscultationLiAn-liang,GaoHong,LinShao-feng,LongJuan.DepartmentofAnesthesiology?HospitalAffiliatedtoGuiyangMedicalUniversity,Guiyang550004,China,Correspondingauthor:GaoHong[Abstract]ObjectiveToevaluatetheeffectofthemethodtodetermineendo

4、trachealtubecuffpressuremethod.MethodsOnehundredandtwentypatientswith(ASA)physicalstatusIorIIundergoingtheelectiveoperationundergeneralanesthesiawererandomlydividedintotwogroups(n=60each).OnegroupisempiricalinflationcalledM.Theothergroupistodeterminetheo

5、ptimaltheendotrachealtubecuffpressurethroughusingauscultaorymethodcalledT.MessuringpressureofusingpressuretransducerafterintubationbytwokindsofMethodstoinflatethecuff.Tocompletetheoperationundertheconditionofmechanicalventilationwithnoairleakage,recordin

6、gthepressurevalueaftertheoperate24h.Thepatientswereaskedtoabserveifsorethroat,cough,expectoration,hoarsenessandbloodstreakedsputum,recodingtheResultsaftervisiting.ResultThepressureintheMgroupwassignificantlyhigherthanthatintheTgroup(P<0.05).IntheMgroupph

7、legmandhoarsenesswassignificantlyhigherthanthatinTgroup(P<0.05),thereisstatisticalsignificance.ConclusionThestudyconfirmsthatausculatation-guidedETTcuffinflationisaneffectivewaytosealtheairwayandassociateswithalowerETTcuffpressureandlowerincideneeofcuff-

8、relatedcomplications.Itisworthyofclinicalpromotion.【Keywords]auscultationendotrachealintubationcuffpressure气管插管机械通气患者的气管黏膜均有不同程度损伤，随着气管导管套囊压力升高，术后并发症发生率增加[1]。有文献报道，气管插管术后咽痛和声音嘶哑等并发症发生率超过50%[2・3],大大影响患者术后满意度。而临床麻醉中普遍使用经验法手捏