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1、采用聽(tīng)診法和傳統(tǒng)方法確定氣管插管套囊壓力的臨床觀察黎安良1高鴻2林少峰1龍娟1(1貴州醫(yī)科大學(xué)貴州貴陽(yáng)550000)(2貴州醫(yī)科大學(xué)附屬醫(yī)院貴州貴陽(yáng)550000)【摘要】目的：評(píng)價(jià)聽(tīng)診法確定氣管導(dǎo)管套囊壓力的效果。方法:120名擇期全麻手術(shù)患者，ASA1-11級(jí)，性別不限，氣管插管后隨機(jī)分M組和T組，每組60例。M組采用經(jīng)驗(yàn)法給氣管套囊注氣，T組采用聽(tīng)診法給套囊注氣，然后兩組均用壓力換能器測(cè)定套囊壓力，確定無(wú)漏氣后機(jī)械通氣靜吸復(fù)合麻醉下完成手術(shù)。術(shù)后24h對(duì)患者進(jìn)行訪(fǎng)視，記錄患者咽痛、咳嗽、咳痰、聲音嘶
2、啞及血絲痰情況。結(jié)果：M組套囊壓力明顯高于T組(P<0.05),M組患者術(shù)后咽痛、咳痰、聲音嘶啞發(fā)生率明顯高于T組(PV0.05)。結(jié)論：聽(tīng)診法確定氣管導(dǎo)管套囊壓力可在合適的套囊壓力下封閉氣道，乂能明顯減少插管后氣道并發(fā)癥，值得臨床推廣?！娟P(guān)鍵詞】聽(tīng)診法；氣管導(dǎo)管；套囊；壓力【中圖分類(lèi)號(hào)】R44【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】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氣管插管機(jī)械通氣患者的氣管黏膜均有不同程度損傷，隨著氣管導(dǎo)管套囊壓力升高，術(shù)后并發(fā)癥發(fā)生率增加[1]。有文獻(xiàn)報(bào)道，氣管插管術(shù)后咽痛和聲音嘶啞等并發(fā)癥發(fā)生率超過(guò)50%[2?3],大大影響患者術(shù)后滿(mǎn)意度。而臨床麻醉中普遍使用經(jīng)驗(yàn)法手捏
