声门下吸引气管导管在危重患者气管切开后气道出血中的应用

Effect of endotracheai tube with subgiottic suction line to stop tracheostomy bleeding in critical patients

目的观察声门下吸引气管导管在气管切开后气道出血危重患者的应用效果。方法35例气管切开后气道出血的危重患者经支气管镜引导，在气管切开处插入带声门下吸引的气管导管，导管前端距离气管隆突上方0．5～1．0em，充入气囊后给予持续声门下吸引，并经气管切开处注入凝血酶。记录患者气道出血情况及处理结果。结果33例（94．29％）气道患者出血均停止；出血时间为6～48h，平均（24．5±4．1）h；气管导管持续使用时间为2～10d，中位时间为4d。结论使用带声门下吸引的气管导管经气管切开处插入气管并持续声门下吸引可以有效控制气道出血，且操作简单，适用于气管切开处至隆突以上气道出血的危重患者。

Objective To observe the effect of endotracheal tube with subglottic suction line on tracbeostomy bleeding in critical patients. Methods This precedure was utilized for 35 critical patients with tracheostomy bleeding. With the help of bronchoscope, the endotracheal tube with subglottic suction line was inserted during tracheostomy to 0.5-1.0 cm above the carina. Then aerocyst of the tube was inflated, vacuum was set up for continuous suction via suction port, and hemecoagulase was injected to the opening of tracheostomy. The airway hemorrhage and treatment results were recorded. Results Tracheostomy bleeding in 33 patients （94.29%） were stopped. The bleeding time ranged from 6 to 48 hours with an average of （24.5±4.1） hours. The tube was in place for 2-10 days with a medium of 4 days. Conclusions Using endotracheal tube with subglottic suction line for critical patients with tracbeostomy bleeding is very effective. This procedure is also very simple and fast, and is best suitable for patient with heavy bleeding in tracheostomy.