麻醉机在临床中的常见使用问题及其解决方法

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                    <p><img class="rich_media_thumb" data-ratio="0.5796875" src="http://mmbiz.qpic.cn/mmbiz/GzHyBFjt9kI4UNFUicVZRVLxNr42oHG4pWTUFbQm5mvnqCHjdnBzY0bXy3zKRfTibtoxXWpO7j3wsIbicwQcgXMDw/0?" data-w="640" style="display: block; width: 670px; visibility: visible !important;"></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(112, 48, 160); box-sizing: border-box !important; word-wrap: break-word !important;">麻醉机是一种比较复杂的医疗器械，它在临床中会出现很多问题，下面就举一些典型的例子，并分析其出现问题的原因，以及解决这些问题的方法。</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;">1、为什么有的麻醉机开机后要过很长一段时间才能起动起来？</span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">麻醉机一般情况下，开机后3至5秒就能起动起来，之所以过很长一段时间起动，通常是9V的断电报警电池容量不足了，9V的断电报警电池一般每年要更换一次，如果不到一年容量就大幅下降说明使用上有缺陷。有些麻醉医师习惯手术做完之后，麻醉机不关，直接把电源拉掉，这样就会造成断电报警，耗费电</span>池。</p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;">2、麻醉机流量不足报警，为什么调节了流量开关之后仍然不起作用？</span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">这种故障临床上发生比较多，特别容易发生在成人折叠球换小儿折叠球，或者小儿折叠球换成人折叠球的时侯，由于折叠球没有装到位就会发生报警消不掉的情况。为了保证患者的潮气量，麻醉机一般都设置零光耦，每一个呼吸周期零位光耦都应得到脉冲信号，一次得不到就会产生报警。</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">3、为什么麻醉机监护仪上氧浓度上不去？</strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">氧浓度传感器通常也有称为氧电极，一般一年加一次电介液。有些用户不用笑气，因此不安装氧浓度传感器不装，可到了一年也要失效。氧浓度传感器装到麻醉机上以后还要进行21%定标。定标是自动的，但是定标时氧浓度传感器一定要从麻醉机上拆下来，放在空气中。根据以上要求使用，氧浓度就会正常。</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;"><br  /></span></p><p style="max-width: 100%; min-height: 1em; text-align: center; box-sizing: border-box !important; word-wrap: break-word !important;"><iframe src="https://v.qq.com/iframe/player.html?vid=b0136j8eq5v&auto=0" width="100%" height="580" frameborder="0"></iframe><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /><span style="max-width: 100%; color: rgb(112, 48, 160); box-sizing: border-box !important; word-wrap: break-word !important;">视听教材：麻醉机</span><span style="max-width: 100%; color: rgb(255, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;">(建议WiFi下观看)</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(255, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">4、麻醉机为什么会漏气？</strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">麻醉机漏气是临床上经常会发生的问题。这里所讲的麻醉机漏气，麻醉师主要有两个感觉，一个感觉是输出潮气量比没定潮气量低，患者肺不张。另一个感觉是好象听到机器中有轻微的漏气声，并且氧气耗费大，这里是指用氧气贮气筒供气。遇到这种情况，要做简单的漏气检查，一方面听声音，结合用肥皂水测试麻醉机内部漏气情况，如果内部不漏的话，可以检查回路泄漏情况。具体方法是取模拟肺一只，用快速按钮充气至2.0Kpa左右，然后按照回路做漏气检查。</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;">5、麻醉机输出潮气量偏小是怎么回事？</span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></span></strong></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">临床全麻手术中，麻醉医师认为根据患者体重计算出来的潮气量是对的，但是监护仪上显示不对，或者是患者肺不张，通气不足，碰到这种情况，首先要检查麻醉机的流量计开了没有，如果没有补充新鲜气体的话就会产生这种情况。其次，可能是因为麻醉机用的时间久了，麻醉呼吸机和回路连接管里会有积水，水产生阻力也会产生上述故障。</span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;"><br  /></span></p><p style="max-width: 100%; min-height: 1em; text-align: center; box-sizing: border-box !important; word-wrap: break-word !important;"><img data-ratio="1.3294346978557505" src="http://mmbiz.qpic.cn/mmbiz/GzHyBFjt9kI4UNFUicVZRVLxNr42oHG4pmTMfq1x61F0s6UjjFm5NKrYT3omSvcpTpmwP1I8vJHIO7BScPWazqA/0?" data-w="513" style="box-sizing: border-box !important; word-wrap: break-word !important; width: auto !important; visibility: visible !important;"></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">6、麻醉机流量计关不到零？</strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;">麻醉机的流量开关是采用针型阀，每次关闭时都要看好关，不要关过头。如果经常关过头，时间久了就损害了针形阀，造成关不到零。</p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"  /></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">7、麻醉机耗气量大，感觉漏麻药，外科医生，麻醉医师都感到头痛，是怎么回事？</strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><br  /></strong></span></p><p style="max-width: 100%; min-height: 1em; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px;">麻醉机耗气量大跟流速开关调得太大有关，通常在保证流量不报警的前提下流速开关尽量调整得小一点，可适当加一些吸气平台。感觉漏麻醉药首先要检查蒸发器，可把蒸发器从座上取下来，检查座上二只O型圈是否完好，然后再检查流量开关，一般开1至1.2L/min，因为开得太大废气排放也大。上述工作做完以后还感觉漏麻药就可从呼吸机后排气管上接一根长塑料管到室外，已解决漏麻药情况。蒸发器。可把蒸发器从座上取下来，检查座上二只O型圈是否完好，然后再检查流量开关，一般开1~1.2升/分，因为开得太大废气排放也大。上述工作做完以后还感觉漏麻药就可从呼吸机后排气管上接一根长塑料管到室外。</span></p><p><br  /></p><p style="text-align: right;"><span style="color: rgb(0, 112, 192); 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