目的:比较持续测压与间断测压方式在重症监护室(intensive care unit, ICU)机械通气患者人工气道气囊管理中的应用效果。方法:采用便利抽样法,抽取2022年10月至2024年9月于周口市中医院ICU采用进行机械通气的患者126例为研究对象,将其按照随机数表法,分为持续测压组和间断测压组,各63例。比较两组机械通气效果,包括机械通气时间、抗生素限定日剂量(defined daily dose, DDD)以及ICU住院时间;比较两组误吸、反流以及呼吸机相关性肺炎(ventilator-associated pneumonia, VAP)发生率;比较两组治疗前、治疗72 h后的呼吸力学指标,包括呼气末正压(positive end-expiratory pressure, PEEP)、气道平台压(plateau pressure, Pplat)、气道峰压(peak inspiratory pressure, PIP);比较两组动脉血气指标,包括动脉氧合指数(partial pressure of arterial oxygen/fraction of inspired oxygen, PaO₂/FiO₂)、二氧化碳分压(partial pressure of arterial carbon dioxide, PaCO₂)。结果:两组机械通气效果比较,持续测压组的机械通气时间、DDD以及ICU住院时间均低于间断测压组,差异有统计学意义(P＜0.05)。两组误吸、反流以及VAP发生率比较,持续测压组总发生率低于间断测压组,差异有统计学意义(P＜0.05)。治疗前,两组PEEP、Pplat、PIP指标水平比较,差异无统计学意义(P＞0.05);治疗72 h后,两组PEEP、Pplat、PIP指标水平均较治疗前降低,且持续测压组PEEP、Pplat、PIP指标水平较间断测压组低,差异有统计学意义(P＜0.05)。治疗前,两组PaO₂/FiO₂、PaCO₂指标水平比较,差异无统计学意义(P＞0.05);治疗72 h后,持续测压组的PaO₂/FiO₂水平较间断测压组高,PaCO₂水平较间断测压组低,差异有统计学意义(P＜0.05)。结论:在ICU机械通气患者人工气道气囊管理中,持续测压组的机械通气效果更好,误吸、反流以及VAP发生率更低,对呼吸力学指标和动脉血气指标的改善效果更好。

Objective: To compare the application effect of continuous pressure measurement and intermittent pressure measurement in the management of artificial airway balloon in patients with mechanical ventilation in intensive care unit (ICU). Methods: A total of 126 patients with mechanical ventilation in ICU of Zhoukou Hospital of Traditional Chinese Medicine from October 2022 to September 2024 were selected as the research objects by convenient sampling method. According to the random number table method, they were divided into continuous pressure measurement group and intermittent pressure measurement group, with 63 cases in each group. The mechanical ventilation effects of the two groups were compared, including mechanical ventilation time, defined daily dose (DDD) of antibiotics and ICU hospitalization time. The incidence of aspiration, reflux and ventilator-associated pneumonia (VAP) were compared between the two groups. The respiratory mechanics indexes including positive end-expiratory pressure (PEEP), plateau pressure (Pplat) and peak inspiratory pressure (PIP) were compared between the two groups before treatment and 72 h after treatment. The arterial blood gas indexes, including partial pressure of arterial oxygen/fraction of inspired oxygen (PaO₂/FiO₂) and partial pressure of arterial carbon dioxide (PaCO₂), were compared between the two groups. Results: Compared with the mechanical ventilation effect of the two groups, the mechanical ventilation time, DDD and ICU hospitalization time of the continuous pressure measurement group were lower than those of the intermittent pressure measurement group, and the differences were statistically significant (P＜0.05). Comparing the incidence of aspiration, reflux and VAP between the two groups, the total incidence of continuous pressure measurement group was lower than that of intermittent pressure measurement group, and the difference was statistically significant (P＜0.05). Before treatment, there was no significant difference in the levels of PEEP, Pplat and PIP between the two groups (P＞0.05). After 72 hours of treatment, the levels of PEEP, Pplat and PIP in the two groups were lower than those before treatment, and the levels of PEEP, Pplat and PIP in the continuous pressure measurement group were lower than those in the intermittent pressure measurement group, the differences were statistically significant (P＜0.05). Before treatment, there was no significant difference in the levels of PaO2/FiO2 and PaCO₂ between the two groups (P＞0.05). After 72 hours of treatment, the PaO₂/FiO₂ level in the continuous pressure measurement group was higher than that in the intermittent pressure measurement group, and the PaCO₂ level was lower than that in the intermittent pressure measurement group, the differences were statistically significant (P＜0.05). Conclusion: In the management of artificial airway balloon in ICU patients with mechanical ventilation, the continuous pressure measurement group has better mechanical ventilation effect, lower incidence of aspiration, reflux and VAP, and better improvement of respiratory mechanics index and arterial blood gas index.