吸入性损伤气管导管脱出原因分析及对策

Reasons and Treatment of Endotracheal Tube Prolapse after Inhalation Injury

目的探讨吸入性损伤气管切开置管,导管脱出的原因及正确的护理方法,提高护士对患者的预见性护理能力。方法对2005年1月2011年3月收治的158例吸入性损伤气管切开患者,其中9例术后发生导管脱出的原因及护理对策进行回顾性总结。结果 9例患者发生导管脱出的主要原因有导管选用不当、剧烈咳嗽、系带过松、气囊充气不足或气囊破裂、切口过大,以及自行拔出。9例发生脱管时间不一,最短于气管切开术后第1天,最长于术后15d,8例经予以紧急处理而尚未影响后续治疗,1例因缺氧时间太长而死亡。结论充分认识吸入性损伤患者气管切开脱管原因,并采取预见性的观察及护理措施,可减少脱管发生,确保患者安全。

Objective To explore the reasons and correct nursing methods of placing endotracheal tubes and tubes prolapsing after incision of trachea for inhalation injury. Methods The clinical data of nine patients with endotracheal tubes prolapse after incision of trachea out of 158 patients suffering from incision of trachea for inhalation injury from January 2005 to March 2011 were retrospectively analyzed. Results The reasons of nine patients suffering from endotracheal tubes prolapse included tubes incongruity, severe cough, too slack bridles, insufficiency and break of aerocysts, too large incision and extraction by themselves. The prolapse time of nine patients was different. The shortest time was postoperative one day, the longest one was postoperative 15 days. Eight patients were treated emergently and healed normally. One patient died of long oxygen deficiency. Conclsions The reasons of endotracheal tubes prolapse after incision of trachea are sufficiently recognized. Predictable observing and nursing methods may decrease the incidence rate of tubes prolapse.