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目的:分析机械通气时气管套管致气管食管瘘的原因,探讨预防措施。方法:随机选取2009年1月-2015年12月期间发生的6例械通气时气管套管致气管食管瘘病例进行说明,结合权威文献复习,对其临床资料进行回顾性分析,总结造成气管食管瘘的主要因素,根据临床实践经验分析相应的预防对策。结果:机械通气过程中,患者出现气管食管瘘的主要因素为气囊压力过高2例,气囊压迫时间过长2例,套管不稳定活动1例,气管结构异常1例;主要预防措施为严密监测气囊内压,防止压力过高现象,同时有效对气管套管进行固定处理,进一步减轻呼吸机相关器件对患者气管的压迫。对于躁动严重患者,要采取必要措施进行镇静处理。结论:在为机械通气患者提供服务时,要加强人工气道、气囊管理力度,减少机械性损伤对患者气管内膜功能的影响,有效减少气管食管瘘发生率。
OBJECTIVE: To analyze the causes of tracheal tube fistula caused by tracheal tube during mechanical ventilation and to discuss the preventive measures. Methods: A total of 6 cases of tracheal tube tracheal esophageal fistula during tracheal intubation were selected from January 2009 to December 2015, and the clinical data were reviewed retrospectively to summarize the results of tracheoesophageal esophageal The main factors of fistula, according to clinical practice and experience analysis of the corresponding preventive measures. Results: The main factors of tracheal esophageal fistula during mechanical ventilation were as follows: balloon pressure was too high in 2 cases, balloon compression time was too long in 2 cases, cannula instability was in 1 case, and tracheal structure was abnormal in 1 case. The main preventive measures were strict Airbag pressure monitoring to prevent the phenomenon of excessive pressure, while effectively tracheal tube fixed treatment to further reduce the ventilator-related devices on the patient’s tracheal pressure. For patients with severe agitation, take the necessary measures to sedative treatment. Conclusion: In the provision of services for patients with mechanical ventilation, artificial airway and balloon management should be strengthened to reduce the influence of mechanical injury on endotracheal function and reduce the incidence of tracheal esophageal fistula.