气囊管理 PPT课件

六安市人民医院重症医学科杨顺银气囊管理与VAP主要内容气囊管理呼吸机相关性肺炎的非抗生素预防措施防止气道漏气保证有效通气量避免误吸防止气道粘膜损伤M1M2M4M3气囊管理的重要性气囊管理4123气囊压力测定与调整气囊的类型气囊的作用相关新技术气囊作用防漏气防误吸气囊类型高压低容型低压高容型等压型根据气囊内压力大小分为三类气囊气囊压力测定专用气囊测压表普通台式血压计手指捏感法固定充气法ABCD气囊压力调整不常规放气理由不常规放气优点保证有效的潮气量维持SpO2的稳定减少了刺激性咳嗽与痰阻的发生血流难以恢复机械通气患者难接受易使护士忽视气囊容积和压力的调整维持患者的PEEP放气不放气？？气囊压力的估测固定注气法312估测法33最小封闭容积（MOV）4少量漏气技术(MLT)气囊压力估测最小漏气技术:将听诊器放于胸前，向气囊内注气，直到听不到漏气声，抽出0.25ml-0.5ml气体，最早闻及少量漏气声，再注气0.25ml-0.5ml。相关新技术囊上滞留物清除声门下吸引相关新技术带吸引装置的气管套管带吸引装置的气管插管呼吸机相关性肺炎是病人接受机械通气48小时后所并发的肺实质感染。是机械通气过程中常见而严重的并发症之一发病率高达18%-60%，病死率高达30%-70%VAP的预防非药物性胃肠道相关措施鼻饲前吸痰控制鼻饲速度选用鼻肠管一般措施手部卫生口腔护理无菌操作保护性隔离人工气道护理人工气道选择气道湿化气囊管理分泌物吸引体位相关措施半卧位动力翻身床VAP预防一般措施：手卫生口腔护理无菌技术保护性隔离VAP的预防体位相关措施：半卧位动力翻身床VAP的预防胃肠道相关措施：鼻饲前吸痰控制鼻饲速度选用鼻肠管VAP的预防人工气道护理：人工气道选择气道湿化气囊管理分泌物吸引ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.AddyourtextAddyourtextAddyourtextAddyourtextAddyourtextAddyourtextYourTextYourTextYourTextYourText气囊压力测定YourTextYourTextYourTextYourText2005200620072008ClicktoedittitlestyleThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.Titleinhere2.Descriptionofthecompany’ssubcontentsThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.1.Descriptionofthecompany’ssubcontentsClicktoedittitlestyleDescriptionofthecontentsThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.TitleinhereTitleinhereTitleinhereClicktoedittitlestyleTextinhereTextinhereTextinhereTextinhereTextinhereTextinhereTextinhereTextinhereContentsContentsContentsContentsContentsThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ClicktoedittitlestyleDescribeavisionofcompanyorstrategiccontents.Describeavisionofcompanyorstrategiccontents.Describeavisionofcompanyorstrategiccontents.Describeavisionofcompanyorstrategiccontents.DescriptionoftheproductsPleasewritedownofasloganforavisionofacompanyinshortly.Pleasewritedownofasloganforavisionofacompanyinshortly.Pleasewritedownofasloganforavisionofacompanyinshortly.Pleasewritedownofasloganforavisionofacompanyinshortly.Vision01Vision03Vision02Vision04CompanyLOGOClicktoedittitlestyleClicktoedittitlestyleTitleinhereThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.DescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsTitleinhereTitleinhereTitleinhereService01Service02Service03LOGOThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ClicktoedittitlestyleClicktoedittitlestyleTitleinhereAddTitleAddTitleAddTitleAddTitleDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsTextinhereTextinhereTextinhereTextinhereDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsClicktoedittitlestyleThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.TitleTextinhereTextinhereTextinhereTextinhereClicktoedittitlestyle200820072006200520042003200220012000DescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecompany’sproductsDescriptionofthecompany’sbusinessDescriptionofthecompany’stechnologyDescriptionofthecompany’scontentsDescriptionofthecompany’sproductsDescriptionofthecompany’sbusinessDescriptionofthecompany’stechnologyDescriptionofthecompany’scontentsDescriptionofthecompany’sproductsDescriptionofthecompany’sbusinessDescriptionofthecompany’stechnologyDescriptionofthecompany’scontentsDescriptionofthecompany’sproductsDescriptionofthecompany’sbusinessDescriptionofthecompany’stechnologyDescriptionofthecompany’scontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsClicktoedittitlestyleClicktoedittitlestyleAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextTextTextTextTextTextThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ClicktoedittitlestyleTextinhereTitleinhereTextinhereTextinhere2005200620072008DescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsDescriptionofthecontentsThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.Clicktoedittitlestyle2005200620072007statisticstitle2007statisticstitle(unit:%)(unit:%)*2007Statisticsagencystatistics*2007Statisticsagencystatistics50%20052006200790%15%96%35%70%Contentsoftheproduct,andpleasefillitout.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ClicktoedittitlestyleThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.80%50%30%20%TitleinhereTitleinhereTitleinhereTitleinhereABCDThankYou!www.themegallery.com3.气囊管理气囊类型低容量高压气囊压力很高，常达100mmHg高容量无压气囊压力等于大气压，为零压高容量低压气囊压力可保持在足够低的水平(约10-30mmHg)气囊压力测定的方法专用气囊测压表固定注气法手指捏感法普通台式血压计3.气囊管理