本文關(guān)鍵詞：持續(xù)植物狀態(tài)氣管切開插管兩種拔管方式的對(duì)照研究　出處：《中國康復(fù)醫(yī)學(xué)雜志》2017年07期 　論文類型：期刊論文

  更多相關(guān)文章： 持續(xù)植物狀態(tài) 氣管切開 氣管套管 拔管

【摘要】：目的:比較持續(xù)植物狀態(tài)(PVS)氣管切開插管患者兩種不同拔管方式(封拔法和換封拔法)的效果。方法:我院植物狀態(tài)促醒中心(123例)入組PVS氣管切開插管患者隨機(jī)分為封拔2步法組、換封拔3步法組。封拔2步法組使用自制封管套封管全封堵48h后,如果呼吸正常者直接拔出套管。換封拔3步法組先更換金屬套管1周后,封管24—48h,如果呼吸正常者則拔出套管。記錄從封管至拔管過程中患者心率、呼吸、血氧飽和度變化以及不同性別、病程、氣管套管留置時(shí)間、拔管時(shí)間、拔管成功率及并發(fā)癥的發(fā)生率。結(jié)果:(1)兩組拔管時(shí)間比較,封拔2步法組拔管時(shí)間明顯短于換封拔3步法組(P=0.034);兩組患者病程為4—12周,比較差異更明顯(P0.05);腦外傷、高血壓腦出血患者拔管時(shí)間比較,封拔2步法組的拔管時(shí)間也明顯短于換封拔3步法組(P0.05)。(2)兩組拔管成功率、并發(fā)癥發(fā)生率比較無顯著性差異(P0.05)。結(jié)論:兩種拔管方式的安全性、成功率、并發(fā)癥發(fā)生率相同,但封拔2步法的拔管時(shí)間較短,特別是病程為4—12周、病因?yàn)槟X外傷與高血壓腦出血者,更加短于換封拔3步法。
[Abstract]:Objective: to compare the effects of two different extubation methods (sealing and replacement) in patients with tracheotomy and intubation for persistent vegetative state PVS. Methods: 123 cases of prowakening center in our hospital). Patients with tracheotomy and intubation by PVS were randomly divided into two steps group. After 48 hours of complete plugging with self-made tube-sealing sleeve, if the person with normal breathing was directly pulled out of the casing, the 3-step replacement group first changed the metal casing after 1 week. For 24-48 h, if the breath was normal, the cannula was pulled out. The heart rate, respiration, blood oxygen saturation, gender, course of disease, and the duration of trachea cannula retention were recorded during the course of tube sealing and extubation. Results the extubation time of the two groups was significantly shorter than that of the 3-step replacement group. The course of disease was 4-12 weeks in the two groups, and the difference was more obvious than that in the control group (P 0.05). Compared with the extubation time of the patients with cerebral trauma and hypertensive intracerebral hemorrhage, the extubation time of the two steps group was significantly shorter than that of the 3-step replacement group. There was no significant difference in the incidence of complications (P 0.05). Conclusion: the safety, success rate and complication rate of the two extubation methods are the same, but the extubation time of two steps is shorter. The course of disease was 4-12 weeks, the etiology was cerebral trauma and hypertensive intracerebral hemorrhage, which was shorter than that of three steps.
【作者單位】： 廣東三九腦科醫(yī)院;中山大學(xué)孫逸仙紀(jì)念醫(yī)院;解放軍第四五八醫(yī)院;
【分類號(hào)】：R472
【正文快照】： 氣管切開術(shù)是意識(shí)障礙患者常用的手術(shù),病情穩(wěn)時(shí)間為(101.1±47.1)d;換封拔3步法組60例,男女定后盡早拔除氣管插管可減少患者潛在的并發(fā)癥[1],各31、29例,年齡(44.6±13.2)歲,其中腦外傷、高血有助于患者早日康復(fù)。目前氣管拔管操作較普遍的壓腦出血、動(dòng)靜脈畸形、缺血缺氧性腦

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉大鵬;;氣管切開術(shù)后氣管內(nèi)肉芽增生的原因分析及防治[J];中國醫(yī)藥指南;2015年31期

2 李迎喜;李玲芳;;金屬氣管套管斷裂脫入氣管1例[J];山東大學(xué)耳鼻喉眼學(xué)報(bào);2015年04期

3 陶冶飛;季勇;;符合氣管插管拔管條件的急性腦外傷術(shù)后拔管862例臨床觀察[J];交通醫(yī)學(xué);2013年06期

4 許俊芳;;金屬氣管內(nèi)套管消毒研究進(jìn)展[J];中國傷殘醫(yī)學(xué);2012年11期

5 陳鄭禮;王光毅;朱世輝;夏照帆;;吸入性損傷氣管切開后肉芽組織增生致氣管狹窄一例[J];中華燒傷雜志;2012年03期

6 徐幼;易慶川;鐘磊;王亮;岳旋弟;李翔;陳繼德;;氣管切開術(shù)后氣管套管兩次滑出氣管搶救成功1例[J];中國耳鼻咽喉頭頸外科;2012年05期

7 葛敏;劉紅艷;;氣管套管的選擇應(yīng)用及護(hù)理[J];吉林醫(yī)學(xué);2006年06期

8 王萍;;氣管切開病人的護(hù)理進(jìn)展[J];中華護(hù)理雜志;2006年06期

9 段攝霞,王紅艷,郭秀茹;ICU氣管插管病人發(fā)生非計(jì)劃性拔管的前瞻性研究[J];國外醫(yī)學(xué).護(hù)理學(xué)分冊(cè);1999年10期

10 鄒冬團(tuán);林宜生;謝敏華;宋義英;程文f，

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