摘要
目的探讨将生理盐水和空气注入一次性使用气管导管套囊后囊内压力的变化。方法在体实验:拟选入全身麻醉下择期行妇科手术的成人患者40例,随机分为生理盐水组(S组)和空气组(A组),两组各20例。两组均在气管插管后用10 ml注射器注入适量生理盐水或空气,并由同一名操作者凭经验以手触摸法评估囊内压至合适范围。使用压力换能器监测囊内压。拔管后,在同一根气管导管注射同等量的介质监测囊内压。套囊对气管壁压力等于插管后的囊内压减去插管前的囊内压。体外实验:实验共采用气管导管(ID 7.0 mm)40根,随机分为两组,每组20根,S组为生理盐水组,A组为空气组。以1 ml为间隔间断向一次性气管导管套囊内分别注射生理盐水或者空气至10 ml,记录套囊内压力变化。结果在体实验:S组气管导管套囊对气管壁压力与A组比较差异有统计学意义,S组明显高于A组(P<0.05)。体外实验:同等容量的介质注入S组和A组间囊内压力差异无统计学意义(P=0.154)。结论在缺乏有效的囊内压力监测设备的情况下,预先在一次性使用气管导管套囊内注射空气直至指感触压法感觉到合适压力,然后将空气抽净,再注入同样体积的生理盐水,该法可以避免经验性直接注入生理盐水后产生的过高的囊内压,从而减少对气道黏膜的损伤。
Objective To investigate the variation of pressure induced by normal saline or air respectively injected in endotracheal tube cuff. Methods The experiment was divided into in vivo and in vitro experiments. For in vivo experiment, 40 cases of female patients undergoing surgery received general anesthesia. They were randomized into saline group （group S） and air group （group A） with 20 in each group. After endotracheal intubation, the endotracheal tube cuff of the two groups were injected saline or air with 10 ml syringe to the appropriate level which was estimated by finger contact method. The pressure of endotracheal tube was recorded by pressure transducer. After tube drawing, the pressure was recorded after injection with the same capacity of saline or air. The pressure of tube to airway wall is the pressure of tube cuff after intubation minus that before intubation. For in vitro experiment, 40 endotracheal tubes were randomized into saline group （group S） and air group （group A） with 20 in each group. The pressure changes were recorded after injection of normal saline or air of 1-10 ml with the interval of 1 ml. In the second experiment the time from pressure recovery to stable level was recorded. Results In the in vitro experiment, the pressure of tube to airway wall in the group S was significantly higher than than that in the group A （P 〈 0.05）. In the in vitro experiment, the pressure had no significant difference between the two groups injected with the same volume of media （P〉 0.05）. Conclusions The pressure induced by injection of the two media in endotracheal tube cuff is similar; however, the recovery time after finger pressing inflatable air sac is obviously prolonged in the normal saline group. Thus there is always illusion when we use finger pressure to test tile endotraeheal cuff pressure.
出处
《中国现代医学杂志》
CAS
北大核心
2016年第21期55-58,共4页
China Journal of Modern Medicine
基金
基金项目:南京市卫生青年人才培养工程第一批次
关键词
气管导管套囊
套囊内压
指感触压法
endotracheal tube cuff
cuff pressure
finger pressing method
