以无囊气管导管为导芯更换气管切开套管法的效果评价(1)
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【摘要】目的 评价以无囊气管导管为导芯更换气管切开套管法的效果， 探讨更换气管套管的有效方法，减少患者不适。方法 将60例需更换气管切开套管的患者随机分为观察组和对照组各30例，观察组利用无囊气管导管为导芯，更换气管套管；对照组采用拔出气管套管后直接插入新套管的传统方法更换气管套管。观察两组患者换管成功率、换管时间及换管期间出现呼吸困难、心率失常和血氧饱和度降低的情况。结果 观察组换管成功率和换管时间均优于对照组，观察组换管期间的呼吸困难、心率失常和血氧饱和度降低的发率与对照组比较明显差异(P<0.05,P<0.01)，具有统计学意义。结论 用气管导管为导芯更换气切套管可显著提高换管成功率和缩短换管时间，有效降低因换管诱发的缺氧并发症,减少患者不适，值得临床推广。
【关键词】气管切开术 气管切开套管 气管导管 效果
中图分类号：R653 文献标识码：A 文章编号：1005-0515(2011)7-056-02
【Abstract】Objective Evaluation with sac endotracheal tube for replacing trachea cannula method effect of tracheostomy tube replacement is an effective method to reduce discomfort to the patient. Methods 60 cases of replacing trachea cannula patients were randomly divided into the observation group and the control group with 30 cases in each group, the observation group without the use of sac endotracheal tube for tracheal cannula, replacement ; control group with pull out after the tracheostomy tube is directly inserted into the casing of traditional method of tracheostomy tube replacement.Two groups were observed in patients with tube exchange success rate, tube replacement time and change the tube during breathing, arrhythmia and decreased oxygen saturation condition.Results the observation group tube exchange success rate and tube changing time was better than the control group, the observation group change during tube difficulty breathing, arrhythmia and lowered oxygen saturation rate compared with the control group significantly (P < 0.05,P < 0.01 ), with statistical significance.Conclusion the endotracheal tube for replacing tracheostomy tube can significantly improve the tube exchange success rate and a shorter tube replacement time, effectively reduce because of changing tube induced hypoxic complications, reduce patient discomfort, worthy of clinical application.
【Key words】Tracheotomy Trachea cannula Tracheal catheter Effect
气管切开术是在颈段第二、三或第三、四气管环之间作切口插入气管套管以形成人工通道，病人直接经气管套管进行呼吸，用于解除或预防喉梗阻引起的呼吸困难或窒息的一种急救技术，也是治疗某些疾病的重要辅助手段，以抢救病人的生命。气管切开术作为有创的气道，气管切开的护理成为专业护理人员研究和探讨的重要课题，为探讨更安全有效的换管方法，2007年1月～2009年6月我院神经外科对30例需更换套管患者应用无囊气管导管为导芯更换套管，取得满意效果，现报告如下：
1 临床资料
1.1 一般资料
气管切开术后须更换套管的60例患者，随机分成两组(观察组和对照组)各30例，其中男38例，女22例，年龄15～65岁。气管切开时间为4～60 d。其中脑出血破入脑室术后20例 ......
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