机械通气条件下不同气囊压力对呼吸机相关性肺炎的影响

摘要

Objective To explore the relationship between different endotracheal tube cuff pressures and ventilator -associat-ed pneumonia (VAP)incidence under mechanical ventilation condition.Method 120 mechanically ventilated ICU patients were randomly divided into four groups based on their different cuff pressures.Special cuff pressure gauge was used to measure the pressures.The pressure of Group Ⅰ was 20 cm H2 O(1 cm H2 O =0.0098 kPa),that of Group Ⅱ was 25 cm H2 O,that of GroupⅢ was 30 cm H2 O,and that of Group Ⅳ was 35 cm H2 O.The incidences of ventilator -associated pneumonia at different pres-sure levels were recorded,so as to determine the optimal endotracheal tube cuff pressure.Statistical analysis was performed by SPSS13.0.Results Ventilator in group Ⅲ caused the lowest incidence of ventilator -associated pneumonia,Group Ⅱ and GroupⅣ had similar indidences,while Group Ⅰ showed the highest incidence.Conclusion During mechanical ventilation,the optimal endotracheal tube cuff pressure is 30 cm H2 O,which has the lowest probability to cause ventilator -associated pneumonia.%目的：探讨在机械通气条件下不同的气管导管气囊压力与呼吸机相关性肺炎发生率的关系。方法：将120例 ICU 病房内进行机械通气的患者随机分为四组，使用专用气囊测压表测量气囊压力分别为 I 组20 cm H2 O（1 cmH2 O ＝0.0098 kPa）、Ⅱ组25 cm H2 O、Ⅲ组30 cm H2 O、Ⅳ组35 cm H2 O，测定不同压力水平下呼吸机相关性肺炎的发生率，从而测定气管导管的最佳气囊压力，对其数据用 SPSS13.0统计软件进行统计学分析。结果：Ⅲ组呼吸机相关性肺炎的发生率最低，Ⅱ组、Ⅳ组发生率相近，Ⅰ组发生率最高。结论：机械通气时气管导管内气囊压力最佳值为　　30 cm H2 O，发生呼吸机相关性肺炎的几率最低。