气管切开48小时内更换气管切开套管的方法探讨  

The approach on methods of replacing tracheostomy tube after incision of trachea in 48 hours

作　　者：李亚霖[1] 秦卫华[1] 孙甲君[1] 游海英[1] 王玲玲[1] 

机构地区：[1]泰山医学院附属聊城市第二人民医院ICU,山东临清252600

出　　处：《中国医师进修杂志（内科版）》2009年第8期29-31,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨临床安全、有效的更换气管切开套管的方法。方法将60例气管切开后48h内须更换气管切开套管ICU患者随机分为A组29例，B组31例。A组采用气管切开套管内置导管法，B组采用传统方法更换气管切开套管。分别记录两组患者更换气管切开套管前后心率、脉搏血氧饱和度（SpO2）变化及操作时间，术中出血量、误入假道发生情况。结果A组操作前后心率及SpO2比较差异无统计学意义，B组操作后心率上升、SpO2下降，与操作前比较差异有统计学意义（P〈0．01或〈0．05）。A组操作时间为（50．5±4．2）s，比B组的（84．9±5．3）s明显缩短（P〈0．05）；A组术中出血量〉3ml及误人假道发生例数（2、0例）明显少于B组（15、5例）（P〈0．01或〈0．05）。结论对于气管切开48h内更换气管切开套管患者，采用套管内置导管法更安全。Objective To explore the more secure and available methods in replacing tracheostomy tube. Methods Sixty patients with incision of trachea were divided into group A （29 cases） and group B （31 cases） randomly. The new method was used in group A with putting a catheter into the old tracheostomy tube before taking it out, and placing the new traebeosto＇my tube under the guide of catheter. While the traditional method was used in group B. The heart rate, SpO2, manipulation lime, perioperative haemorrhage, and the condition of entering the false passage were recorded. Results The heart rate, SpO2 were no significant difference before and after manipulation in group A, but the heart rate increased and SpO2 decreased in group B （P〈0.01 or 〈0.05）. The manipulation time was （50.5 ±4.2） s in group A, and （84.9 ± 5.3） s in group B（P〈 0.05）. The perioperative haemorrhage 〉 3 ml and the condition of entering the false passage in group A （2 cases, o case） were less than those in group B （ 15 cases, 5 cases）（P 〈 0.01 or 〈 0.05 ）. Conclusion The new method in replacing tracheostomy tube which use an input catheter is more security and more availability.

关 键 词：气管切开术 气管切开套管 更换 

分 类 号：R473.6[医药卫生—护理学] R657.4[医药卫生—临床医学]