有创机械通气患者气囊漏气的急救护理

The emergency care of gasbag leakage to the patients with invasive mechanical ventilation

目的探讨有创机械通气患者气囊漏气的急救护理。方法对我院急诊科监护室2009年1月-2012年10月96例应用气管插管或气管切开机械通气患者发生气囊漏气现象的处理过程进行回顾性分析。结果 96例气囊漏气患者中,68例气囊充气后48 h内未补气;10例气囊充气后24 h内未补气;12例气管切开置管过程中,血管钳扎破气囊;2例气管切开伤口过大,吸除气囊上滞留物时气囊被吸破;3例气管切开置管时,气囊被气管软骨组织扎破;1例护士做口腔护理时不慎剪掉外气囊。96例患者因被及时发现并得到及时处理而脱离了生命危险。结论监测气囊压力,及时发现气囊漏气,及时采取有效的急救措施是有创机械通气患者气囊护理的关键。

Objective To investigate the emergency care of gasbag leakage to the patients with invasive mechanical ventilation. Methods By retrospective study of the 96 cases gasbag leakage and treatment with mechanical ventilation in emergency intensive care unit in the central hospital of Taian from January 2009 to October 2012.Results In 96 patients of gasbag leakage,there were 10 aerated gasbag cases without filling again in 24 hours,68 cases without filling again in 48 hours.12 cases gasbags were punctured by forceps in the tracheotomy proess.2 cases gasbags were sucked break when the secretions are sucked.3 cases gasbags were punctured by the tracheal cartilage in the tracheotomy proess.1 case gasbag was cut accidentally in the process of oral care.96 patients were out of danger because of timely detection and treatment.Conclusion Gasbag pressure monitoring, timely detection and treatment are the key of gasbag leakage nurse in invasive mechanical ventilation.