论文部分内容阅读
某些因素容易引起气管插管麻醉后喉气管并发症。同年龄的女性比男性的气管小,粘膜又较薄,故易受损伤。婴儿的正常声门裂缝约14mm~2,周围1mm 厚的水肿即可使缝隙缩小35%。短颈和小下颌插管难度大,易直接造成损伤。又由于解剖关系,导管不能顺应和弯曲,而在杓状软骨后联合区造成压迫损伤。心输出量过低常合并组织灌注不足和营养不良,就更影响组织抵抗力,气道的并发症更增多。上呼吸道有炎症,粘膜易受侵蚀软骨继发感染,往往引起狭窄。导管的损伤包括擦伤粘膜,撕脱声带韧带,使杓状软骨移位,甚至穿通气管。置管时,如坚硬的管芯伸出导管,更易发生损伤。导管的套囊可损伤粘膜,套囊压力即使很低,压迫1小时粘膜上的纤毛运动受损害,3小时开始脱屑,到24小时往往整个上皮坏死脱落,而发生感染。大的薄壁套囊发生的损伤少于小的卵圆形套囊。套囊内压小于平均毛细血管压(25mmHg)粘膜就有较好的灌注,并发症也少。声带下区是特别容易发生狭窄的区域,故膨胀的套囊不应留置在该处。搬动病人,呼吸器的传入冲动,以及不完全声带麻痹均加强导管和套囊在粘膜上的切力。导管必须够大,才能通气和吸出分
Some factors easily lead to laryngotracheal tube tracheal anesthesia complications. Women of the same age smaller than the trachea of men, mucous membrane and thin, so vulnerable. Baby’s normal glottis crack about 14mm ~ 2, 1mm thick around the edema can make the gap reduced by 35%. Short neck and small mandibular intubation difficult, easy to directly cause damage. Due to the anatomic relationship, the catheter can not conform to and flexion, resulting in compression damage in the posterior arytenoid cartilage. Cardiac output is often associated with poor tissue perfusion and malnutrition, even more affect tissue resistance, airway complications even more. Upper respiratory tract inflammation, mucosa vulnerable to erosion of cartilage secondary infection, often cause stenosis. Catheter injuries include mucosal abrasions, avulsion of the vocal cords, displacement of the arytenoid cartilage, and even wearing of the trachea. During catheterization, hard catheters stick out of the catheter and are more prone to injury. Duct cuffs can damage the mucosa, even if the cuff pressure is very low, oppression 1 hour mucosal ciliary motility damage, 3 hours began to desquamation, necrosis of the epithelium is often 24 hours off, and the infection occurs. Large thin-walled cuff damage occurs less than a small oval cuff. Cuff pressure is less than the average capillary pressure (25mmHg) Mucosal there is better perfusion, complications are less. The area under the vocal cords is a particularly stenosed area, so inflated cuffs should not be left there. Movement of the patient, afferent impulse of the respirator, and incomplete vocal cord paralysis both enhance the mucosal shear force of the catheter and cuff. Catheters must be large enough to breathe and aspirate points