摘要
目的探讨≥2次气管切开术后气道处理措施。方法回顾性调查该院2005年1月~2012年1月经历≥2次气管切开术的23例患者出现气道狭窄等各种并发症的分布情况,在处理上强调机械通气的动态监测、有效的吸引技术、充分的气道湿化、严格的气道管理、预防感染、心理护理等措施。结果 3例疤痕增生、2例套管偏移脱出和6例痰痂形成致气道狭窄患者症状改善,4例切口感染和7例呼吸机相关性肺炎患者临床症状及体征有不同程度的改善,3例皮下气肿患者,气肿吸收,4例拔管困难患者中,死于多器官功能衰竭2例,2例带气管套管出院。结论在≥2次气管切开术后的处理中行之有效的预防措施十分重要,能够有效地减少气道狭窄等并发症的发生率,对于促进术后的康复具有重要的临床意义。
[Objective] To investigate airway management measures after≥2 times airway tracheotomy. [Methods] A retrospective survey was made in our hospital from January 2005 to January 2012, 23 patients experienced≥2 times tracheotomy with various complications distribution of airway stenosis, stressed that in dealing with the dynamic monitoring of mechanical ventilation, attract skilled adequate airway humidification, airway management, prevention of infection, psychological care and other measures. [ Results ] Of three patients with scarring, two cases casing offset prolapse and six cases of sputum formation induced airway narrowing in patients with symptoms improve, four cases of wound infection and 7 cases of ventilator-associated pneumonia in patients with clinical symptoms and signs improved to varying degrees, 3 cases of subcutaneous emphysema , emphysema absorbed four cases extubation difficulties , patients died of multiple organ failure in two cases, and two cases with tracheal can- nula was discharged. [ Conclusion ] ≥ 2 times tracheal incision for the postoperative treatment of effective preventive measure is very important, can effectively reduce the incidence of complications of airway stenosis, has important clinical significance for the promotion of the postoperative rehabilitation.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第34期92-95,共4页
China Journal of Modern Medicine
关键词
多次
气管切开
并发症
预防
处理
repeatedly
traeheotomy
complications
prevention
treatment
