16例气管插管并发气管食管瘘的临床护理

Clinical care of 16 cases with endotracheal complicated with intubation tracheo-esophageal fistula

目的探讨气管插管并发气管食管瘘的临床护理方法与效果。方法选择因不同原因行气管切开套管置入留置过程中发生气管食管瘘的患者16例,观察护理方法与临床效果。结果气管食管瘘的平均发生时间为(46.5±18.6)d;采用带膜金属气管支架置入后的9例患者,呛咳及进食困难不再发生;另有4例空肠造瘘管饲和3例留置套管并且胃管鼻饲的患者其营养状态良好,水电解质保持平衡。结论气管切开套管置入留置时,应加强套管和球囊的护理以防气管食管瘘发生;气管食管瘘发生后,对应用带膜金属支架气管或食管置入,应掌握其专科配合和护理技术;对气管食管瘘保守治疗者,应熟练掌握管饲及其护理。

Objective To investigate the care methods and results of the intubation tracheo-esophageal fistula.Methods We chose 16 patients with various indwelling tracheotomy tube into the trachea esophageal fistula,observe the nursing and clinical results.Results The tracheal esophageal fistula,the average time of occurrence of 46.5 ± 18.6d;9 patients with metallic tracheal stent after implantation had no cough and difficult eating;another four cases of jejunal feeding and 3 cases of fistula indwelling tube and stomach tube feeding in patients with good nutritional status of its water and electrolyte balance.Conclusions People indwelling tracheostomy tube set,the casing and the balloon should be strengthened to prevent the tracheo-esophageal fistula care;if tracheo-esophageal fistula occurred,on the application of membrane-metal stent the trachea or esophagus that puts people,we should have the special care techniques;conservative treatment of tracheo-esophageal fistula,should be familiar with tube feeding and care.