多参数监护仪常见故障分析与处理

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                    <p dir="ltr" style="line-height: 1.5em;"><img src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6M5ZOUw4MDPric74wQnsRyPrJz9CP7zCvU19GI1e4iahicghpxicjDnrf6BBsCaR9lGrQjDydQvjic7mXA/0" data-ratio="0.18972332015810275" data-w="" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6M5ZOUw4MDPric74wQnsRyPrJz9CP7zCvU19GI1e4iahicghpxicjDnrf6BBsCaR9lGrQjDydQvjic7mXA/0" style="color: rgb(62, 62, 62); white-space: normal; font-family: 宋体; font-weight: bold; background-color: rgb(255, 255, 255); font-size: 14px; line-height: 24px; word-wrap: break-word !important; box-sizing: border-box !important; width: auto !important; visibility: visible !important;"  /><span style="font-size: 18px;">随着我国医学工程技术的飞速发展，多参数生理监护仪已不再局限于手术室，重症病房等生命重点保障科室中使用，而是逐步普及到了一</span><span style="font-size: 18px;">般病房，一批性价比高国产监护仪也被各医院大量使用，如笔者单位所用监护仪中国产和进口品牌共计十余种，这给临床使用和维护多少带来些麻烦，但它们的原理大同小异，万变不离其宗，只要熟知其原理，使用和维修保养中遇到的诸多问题就不难解决，再者很多故障现象并不是仪器本身的问题，而是临床医技术人员在使用中不熟练或误操作引起的，因此为医护人员做使用前培训也颇为重要。本文结合本人多年来的工作经验体会，以SD2003型监护仪为例，介绍多参数监护仪在临床操作和故障处理中最常见的一些具有共性的问题和处理方法，供同行参考。</span></p><p dir="ltr"><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障一：插交流电源后，面板绿灯不亮，按POWER键无法开机，屏幕无显示。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：检查交流插线头座接触好否，机内电源板上保险丝断否，机内电池是否没电，如以上所述都没问题，则一般是电源板出现故障。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障二：不插交流电源，按POEWER键无法用电池开机，面板绿灯不亮，屏幕无显示。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：电池可能无电，应插上交流电源后再开机，机器若长期闲置过，应充电8min后再开机试试，再有可能铅酸电池使用2年后性能慢慢下降，电池供电时间慢慢变短影响使用，需要更换电池。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障三：开机时机器失去控制，所有按键均无效。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：若偶尔遇上按键无效可能是机器开机时间过长导致，可以重新开机关机即可恢复正常。另外个别按键受阻也是导致这一现象的常见原因。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障四：机内温升偏高，散热风扇不转。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：检查风扇叶片有否受阻或被异物卡住或者风扇电机烧毁，如有则需维修或更换。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障五：屏幕显示有缺点缺线情况，但背光亮，各按键、功能均正常有效。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：按键和功能有效提示主控电路正常，一般为机内工控板到LCD的插线头座接触不良所致。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障六：接好导联线无心电波形，屏幕显示导联脱落。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：检查导联线各段有否断或插头座接触不良，受试者电极片处有否接触不良，再者心电电极片上的小块砂纸是用来磨去皮肤上的皮屑用的，应该使用并且把皮肤擦洗干净，这样可减少电阻，以改善心电波形质量。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障七：心电有50Hz干扰，基线粗，并且基线和心率值时常漂移。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：电极片有否接触好，有否失效，皮肤是否清洗干净，病人有否乱动或碰到金属，机内电脑是依据最近8次心电R波平均时程推算心率值，要获得良好正确的心率值，必须选择心电R波比较清晰而且无干扰的导联。病人乱动或刚刚切过导联或导联脱落恢复后，心电波并未稳定下来，此时心率值会发生飘动，但几秒后会慢慢自动恢复正常。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障八：无血氧波形和数值，波形乱。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：探头内无红光闪则探头坏或插头座接触不良，病人是否乱动或手臂是否受压，室温低时勿让手臂外露，手臂温度太低会造成指尖血流减少影响测量。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障九：测量血压数值与水银血压计相比有误差。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：振荡法测压模块通过记录袖带中压力变化推算平均压收缩压舒张压，同有创血压值比，振动法比水银血压计法误差小稳定性高，后者易受人为因素影响，由于方法不同与生物个体差异存在，临床中偶尔出现个别误差属正常。但如果偏差太大，应检查袖带气管有无漏气，测压时体位及捆绑位置正确否，测压勿隔衣物，袖子卷到袖带上方也易阻碍血流出错。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障十：测不出血压值来。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：当按下START键时，如果听不到气泵工作的声音，应打开机壳，在按一下START的状态下，测量J7是否有+6?V供电，如有则气泵坏应换之；如果气泵有声音，但袖带内压力上不去，应检查袖带中橡胶囊和橡胶管密封有否破裂；如果袖带压力上去但不放气，则检查气阀或气阀供电无所致，应更换气阀或维修供电电源。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障十一：测压中成人测不出来而对婴儿有效。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：一般是由于成人婴儿设置错误所致，如果对成人使用婴儿设备测压，容易造成打气压力不够需要补气，测不出结果。如果对婴儿使用成人设置测压，由于打气过高容易造成肢体损害，严重可导致坏死。</span></p><p><br style="padding: 0px; margin: 0px;"  /></p><p><br style="padding: 0px; margin: 0px;"  /></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">监护仪故障十二：屏幕上的显示值不断反白闪动显示。</span></p><p style="line-height: 1.5em;"><span style="font-size: 18px;">分析与处理：某些屏幕上的显示值变为反白闪动状态，表示代表的值已超出预设的报警上下限，特别注意，面板上的报警键值开关报警声音，但不能开关屏幕的闪动与报警灯。</span></p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" data-ratio="0.14784394250513347" data-w="487" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" style="word-wrap: break-word !important; 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color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; line-height: 28px;">定期推送</span><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(255, 192, 0); margin: 0px; padding: 0px; border: 0px; line-height: 28px;">医械资讯</span><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; margin: 0px; padding: 0px; border: 0px; line-height: 28px;"><span style="max-width: 100%; margin: 0px; padding: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; color: rgb(0, 176, 80); word-wrap: break-word !important; box-sizing: border-box !important;">厂家推介</span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; 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