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| 液压型气管导管气囊压管理装置对妇科腹腔镜手术中气囊压的影响 |
| Impact of the hydraulic tracheal tube cuff pressure management device on cuff pressure in gynecological laparoscopic surgery |
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| DOI：10.12089/jca.2025.01.012 |
| 中文关键词: 气管导管 气囊压 自动充气装置 妇科 腹腔镜 |
| 英文关键词: Endotracheal tube Cuff pressure Auto-inflation device Gynecology Laparoscopy |
| 基金项目: |
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| 中文摘要: |
目的：评估自制液压型气管导管气囊压管理装置对妇科腹腔镜手术中气囊压的影响。
方法：选择择期行妇科腹腔镜手术患者55例，年龄18～64岁，BMI 18.5～28.0 kg/m2，ASA Ⅰ—Ⅲ级。采用随机数字表法将患者分为两组：试验组(n=28)和对照组(n=27)。在全身麻醉气管插管后，试验组气管导管气囊通过三通和液压型气管导管气囊压管理装置（倒置墨菲管的输液器）相连，调整墨菲管内和输液袋内的液面高度差为27 cm；对照组气管导管气囊使用气囊测压表充气至27 cmH2O。记录手术开始前1 min（T1）、人工气腹开始后1 min（T2）、人工气腹结束前1 min（T3）和人工气腹结束后1 min（T4）的气囊压及气囊压与初始气囊压(27 cmH2O)的偏差值（气囊压与初始气囊压之差）。记录麻醉复苏期的气囊压最高值、最低值、最高值和最低值与初始气囊压的偏差值。
结果：与初始气囊压比较，对照组T1—T3时气囊压和麻醉复苏期气囊压最高值明显升高（P<0.05），T4时气囊压和麻醉复苏期气囊压最低值明显降低（P<0.05）；试验组麻醉复苏期气囊压最高值明显升高，最低值明显降低（P<0.05）。与对照组比较，试验组T1—T4时及麻醉复苏期的气囊压偏差值明显降低（P<0.05）。
结论： 液压型气管导管气囊压管理装置在妇科腹腔镜手术中能有效维持术中气囊压稳定。 |
| 英文摘要: |
Objective: To evaluate the effectiveness of a self-made hydraulic type tracheal catheter cuff pressure management device on maintaining stable cuff pressure in gynecological laparoscopic surgery.
Methods: Fifty-five patients who underwent elective gynecological laparoscopic surgery, aged 18-64 years, BMI 18.5-28.0 kg/m2, and ASA physical status Ⅰ-Ⅲ, were selected. The patients were divided into two groups using random number table method: trial group (n = 28) and control group (n = 27). After tracheal intubation under general anaesthesia, the tracheal catheter cuff in the trial group was connected to a hydraulic-type tracheal catheter cuff pressure management device (an infuser with an inverted Murphy's tube) via a three-way, and the difference in the height of the liquid level inside the Murphy's tube and inside the infusion bag was adjusted to 27 cm. The tracheal catheter cuff in the control group was inflated to 27 cmH2O using a cuff pressure gauge. The cuff pressure and the deviation of the cuff pressure (the difference between the cuff pressure and the initial cuff pressure) from the initial cuff pressure (27 cmH2O) were recorded 1 minute before the start of surgery (T1), 1 minute after the start of artificial pneumoperitoneum (T2), 1 minute before the end of artificial pneumoperitoneum (T3), and 1 minute after the end of artificial pneumoperitoneum (T4). The highest and lowest cuff pressures during the anesthesia recovery period and their deviations from the initial cuff pressure were also recorded.
Results: Compared with the initial cuff pressure, the cuff pressure in the control group was significantly increased at T1 - T3, and during the highest value of the recovery period (P < 0.05), and was significantly decreased at T4 and during the lowest value of the recovery period (P < 0.05); the highest cuff pressure during the recovery period was significantly increased, and the lowest cuff pressure was significantly decreased in the trial group in the trial group (P < 0.05). Compared with the control group, the cuff pressure deviation in the trial group was significantly reduced at T1-T4 and during the recovery period (P < 0.05).
Conclusion: The hydraulic tracheal tube cuff pressure management device is effective on maintaining stable cuff pressure in gynecological laparoscopic surgery. |
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