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目的报道3例气管切开长期机械通气的老年患者突然出现呼吸困难的情况,分析其发生原因并提出处理对策。方法收集气管切开的长期机械通气的老年患者为观察对象,监测其呼吸频率及血氧饱和度,在病情平稳的基础上突然出现呼吸困难的情况。结果在保障呼吸机不漏气的前提下,3例患者均存在过度充气,气囊将导管内口部分堵塞情况,在体位变动时阻塞加重导致患者呼吸困难。分析其原因考虑与气管软化扩张[2-3]、气管套管老化等有关。结论气管切开长期机械通气的老年患者突然出现呼吸困难需要警惕气囊阻塞导管内口的可能。
Objective To report the sudden onset of dyspnea in 3 elderly patients with tracheostomy and long-term mechanical ventilation, analyze its causes and propose countermeasures. Methods Aged patients with long-term mechanical ventilation after tracheotomy were selected as observational objects, respiratory rate and oxygen saturation were monitored, and dyspnea suddenly appeared on the basis of stable condition. Results In the premise of airtight protection of ventilator, all three patients were over-inflated. The air-bag partially blocked the internal port of the catheter and increased the obstruction of the patient when the position changed. Analysis of the reasons to consider the expansion of the trachea and softening [2-3], trachea casing aging and so on. Conclusions Abrupt dyspnea in elderly patients with long-term mechanical ventilation after tracheostomy may be necessary to guard against the possibility of the balloon obstructing the inner mouth of the catheter.