重庆医科大学学报
重慶醫科大學學報
중경의과대학학보
UNIVERSITATIS SCIENTIAE MEDICINAE CHONGQING
2010年
1期
146-148
,共3页
气管切开导管%无创机械通气%序贯脱机
氣管切開導管%無創機械通氣%序貫脫機
기관절개도관%무창궤계통기%서관탈궤
Catheter for tracheotomy%Non-invasive mechanical ventilation%sequential invasive-noninvasive off-line
目的:探讨对常规有创-无创序贯脱机困难者,采用保留气管切开导管行无创机械通气以达到脱机目的的可行性.方法:回顾分析2006年1月至2007年12月我院中心ICU15例反复脱机困难患者.采取保留气管切开导管行无创面罩机械通气.当患者不能自主有效地清除呼吸道分泌物时,采取护理干预手段,经气切导管吸痰,以达到有效清除呼吸道分泌物的目的.结果:15例有创通气时间(36.87±21.82)d,无创通气时间最短5 d,最长38 d,平均11.5 d,全部成功脱机后逐渐拔除气切导管.脱机成功率与上年同期比较明显增高.结论:对意识欠清、对呼吸道分泌物自主廓清能力较弱、反复肺部感染致反复脱机困难的患者,采取保留气管切开导管行无创机械通气,可促进患者有效脱机,提高了脱机成功率.
目的:探討對常規有創-無創序貫脫機睏難者,採用保留氣管切開導管行無創機械通氣以達到脫機目的的可行性.方法:迴顧分析2006年1月至2007年12月我院中心ICU15例反複脫機睏難患者.採取保留氣管切開導管行無創麵罩機械通氣.噹患者不能自主有效地清除呼吸道分泌物時,採取護理榦預手段,經氣切導管吸痰,以達到有效清除呼吸道分泌物的目的.結果:15例有創通氣時間(36.87±21.82)d,無創通氣時間最短5 d,最長38 d,平均11.5 d,全部成功脫機後逐漸拔除氣切導管.脫機成功率與上年同期比較明顯增高.結論:對意識欠清、對呼吸道分泌物自主廓清能力較弱、反複肺部感染緻反複脫機睏難的患者,採取保留氣管切開導管行無創機械通氣,可促進患者有效脫機,提高瞭脫機成功率.
목적:탐토대상규유창-무창서관탈궤곤난자,채용보류기관절개도관행무창궤계통기이체도탈궤목적적가행성.방법:회고분석2006년1월지2007년12월아원중심ICU15례반복탈궤곤난환자.채취보류기관절개도관행무창면조궤계통기.당환자불능자주유효지청제호흡도분비물시,채취호리간예수단,경기절도관흡담,이체도유효청제호흡도분비물적목적.결과:15례유창통기시간(36.87±21.82)d,무창통기시간최단5 d,최장38 d,평균11.5 d,전부성공탈궤후축점발제기절도관.탈궤성공솔여상년동기비교명현증고.결론:대의식흠청、대호흡도분비물자주곽청능력교약、반복폐부감염치반복탈궤곤난적환자,채취보류기관절개도관행무창궤계통기,가촉진환자유효탈궤,제고료탈궤성공솔.
Objective: To investigate the feasibility of the getting off-line method by noninvasive mechanical ventilation while keeping the tracheotomy catheter for patients who had difficulty with conventional Sequential Invasive-Noninvasive off-line means.Methods:Data fron 15 patients with difficulty in off-line in ICU between January,2006 and December,2007 were analyzed.Once they had problems in clearing respiratory tract secretion spontaneously,aspiration of sputum through tracheotomy catheter would be applied to keep the airway unobstructed.Results:The invasive ventilation time of the 15 patients were(36.87±21.82)days.The average time of noninvasive mechanical ventilation were 11.5days,the shortest 5 days and the longest 38 days,respectively.All patients successfully got off-line.The rate of success was higher than that during the same period of 2004～2005 in comparison,when this method was not carried out. Conclusions:It is effective to apply the noninvasive mechanical ventilation while keeping the tracheotomy catheter to the patients who have difficulty in getting off-line due to unconsciousness,difficulty in clearing respiratory tract secretion spontaneously and repeated pulmonary infection,with enhanced success rate of sequential invasive-noninvasive off-line and emphasize to nurse mechanical ventilation.
