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气囊漏气试验（cuff leak test，CLT）：主要是比较排空气管插管气囊前后潮气量的变化，来协助评估患者拔管后是否有上呼吸道阻塞的问题，进而降低拔管后重新插管的伤害。
操作前准备：1.用物准备简易呼吸器、10ml注射器、吸痰管、测压表。
2.患者准备：充分清除口鼻腔及气囊上滞留物。
操作流程：1.将模式更换为V-A/C，根据患者情况设置合理参数。
2.将监测波形更换为容量-时间曲线。
3.将气囊完全放气，待患者稳定后，连续记录5-6次呼出潮气量的大小。
取其中最小3个数的平均值。
4.计算吸-呼出潮气量的差值或相差率，并据此判断气囊漏气试验是否阳性。
5.将气囊充气，测量并维持合适气囊呀。
6.恢复原模式及参数。
结果判断：气囊漏气试验阳性标准（成人）：1.潮气量的差值＜110ml；2.（吸气潮气量-呼气潮气量）/吸气潮气量＜15%。
结论：阳性结果预计UAO或再插管具有较高的敏感性；阴性结果不能除外UAO或再插管的可能。
CLT阳性结果的处理：延迟气管插管或采用气管切开；无创正压通气CPAP；应用气道扩张药物；应用糖皮质激素；影响CLT的因素：气管导管管径是粗细；松开气囊后患者呛咳反射明显；气囊周围的痰液堆积影响周围缝隙。
CLT病人的选择：不应常规应用于临床，假阳性：肥胖、主支气管病变。
实施CLT：拔管后易发生上气道阻塞的高危人群。
拔管后易发生UAO的高危因素：儿童、女性患者、气管插管时间（超过36小时）、反复插管患者、气管插管的管径、近期气道损伤。
注意事项：注意监测患者的生命体征、呼吸力学及主观感受，如有不适应及时停止。
吸气潮气量（机器设置或患者自主吸气时的潮气量）；呼气潮气量（机器监测所得的实际值）。
上气道梗阻（upper airway obstrucion，UAO）：定义：由于声门水肿或大气道异物（痰痂或肿瘤）所致上气道气流严重受阻的临床急症。
临床表现为喉头及喉头下部大气道损伤、水肿及肉芽肿形成。
体征：轻微者可闻及上气道高调喘鸣音，严重者可出现呼吸窘迫，导致呼吸衰竭。
气囊漏气试验操作流程英文回答：The process of conducting an airbag leak test involves several steps to ensure the safety and functionality of the airbag system. Here is a general outline of the operation flow for conducting an airbag leak test:1. Preparation: The first step is to prepare thetesting equipment and the airbag system that will be tested. This may involve setting up the testing chamber, connecting the airbag to the testing equipment, and ensuring that all necessary tools and materials are readily available.2. Pressurization: The next step is to pressurize the airbag system to the specified pressure level. This can be done using a regulated air supply and monitoring the pressure gauge to ensure that the correct pressure is achieved.3. Observation: Once the airbag system is pressurized,it is important to carefully observe the system for any signs of leakage. This may involve visually inspecting the airbag for any visible leaks, as well as using specialized equipment such as leak detection sprays or sensors toidentify any areas of concern.4. Recording: Any observations or findings during the leak test should be accurately recorded. This may include documenting the pressure levels, any observed leaks, andany actions taken to address any issues that are identified.5. Analysis: After the initial leak test is conducted,it is important to analyze the results and determine the next steps. This may involve conducting additional tests, making repairs or adjustments to the airbag system, or certifying the system as being leak-free.6. Reporting: Finally, a detailed report of the airbag leak test should be prepared. This report should include a summary of the testing process, the results of the test,any actions taken, and any recommendations for futuremaintenance or testing.中文回答：进行气囊漏气试验的操作流程包括几个步骤，以确保气囊系统的安全和功能性。
气囊漏气试验操作流程英文回答：The procedure for conducting an airbag leak test is crucial to ensure the safety and functionality of the airbag system. Here are the steps to perform an airbag leak test:1. Preparation: Before starting the test, ensure that the vehicle is parked in a well-ventilated area with enough space to work around the airbag system. Also, make sure to disconnect the vehicle's battery to prevent accidental deployment of the airbag.2. Accessing the airbag: Locate the airbag module and carefully remove the cover to access the airbag assembly. This may require removing screws or bolts that secure the cover in place.3. Pressurizing the airbag: Using a specialized tool,such as an airbag pressure tester, connect it to the airbag assembly and pressurize the system to the recommended pressure level. This will help in detecting any leaks in the airbag or its components.4. Leak detection: Once the airbag system is pressurized, carefully inspect the entire assembly for any signs of leakage. This includes checking the airbag itself, the inflator, and the airbag housing for any visible leaks or damage.5. Recording the results: Document the pressure readings and any observations during the leak test. This information will be useful for determining the integrity of the airbag system and for future reference.6. Reassembly: After completing the leak test and documenting the results, reassemble the airbag assembly and ensure that it is securely fastened in place.7. Functional test: Once the airbag assembly is reinstalled, perform a functional test to ensure that theairbag system is operating as intended. This may involve reconnecting the vehicle's battery and using a diagnostic tool to check for any error codes related to the airbag system.中文回答：进行气囊漏气试验的操作流程对于确保气囊系统的安全和功能至关重要。
气囊漏气试验如何做当医生要求您去评估患者以查看她是否准备好拔管时，您是重症监护室的一名全新人员。
她是一名 45 岁的女性，因使用赖诺普利引起的血管性水肿继发性呼吸衰竭入院。
你焦急地走进房间去看她，她醒着，听从命令，并且已经忍受了 45 分钟的压力支持 5/5 自主呼吸试验 (SBT)。
您想拔管，但意识到她处于拔管后喘鸣的高风险中。
你现在应该做什么？为什么我们关心拔管后喘鸣？喘鸣是由快速、湍流的气流通过胸外上呼吸道狭窄或部分阻塞的部分产生的，可以模仿喘息，有时听起来像吱吱声。
这些区域是咽部、会厌和喉部。
这些区域之外的结构也可能包括淋巴结、肿块和食道问题。
拔管后喘鸣占拔管失败的4-37%，由于缺乏以标准化方式对此进行探索的研究，因此这个范围很广。
虽然这些患者的重新插管率未知，但所有重新插管中约有 15% 是由于拔管后喘鸣或喉部水肿所致。
拔管后喘鸣的危险因素是过度的气道操作（即：气道手术或创伤性插管）、长时间的插管尝试（超过 10 分钟）、较大的气管插管、插管持续时间超过 36 小时、插管时情绪激动、气囊压力高、反复插管、女性、儿童、外伤患者、短颈和已知气道病理，如气管软化或气管狭窄。
在这些情况下，并且仅在这些情况下，气囊泄漏测试可用于预测患者拔管后喘鸣的风险。
什么是气囊泄漏测试？理想情况下，直接观察气道和声带以评估水肿或喉部肿胀是识别拔管后喘鸣风险的最佳方法。
鉴于在 ETT 在位时执行此操作的难度，气囊泄漏是下一个最佳选择。
它是一种床边评估，用于预测插管患者拔管后喘鸣的风险。
这是一种床旁评估，用于预测插管患者拔管后喘鸣的风险。
它可以在大多数插管病人身上进行，但那些由于声门上结构阻塞而插管的病人除外，这些结构在气管导管插入时被夹住。
正确的气囊泄漏测试如下：吸除气管内和口腔分泌物并将机械呼吸机设置为辅助控制模式，患者接受 10ml/kg 理想体重的容量循环通气气囊充气后，确保吸气和呼气潮气量相似并记录该值。
