自制可冲洗气管导管的临床应用

目的观察自制可冲洗气管导管清除声门下分泌物的有效性和安全性。方法以普通气管导管及普通吸痰管为原材料,制作可冲洗的气管导管应用于气管切开患者,与市售可冲洗气管导管比较,观察两种导管的通畅程度、冲洗管堵塞例数、每日声门下分泌物总量、切口感染例数,并作安全性评估。结果两种可冲洗导管比较,留管3 d以上,市售导管抽吸阻力增加,管腔堵塞6例(85%);自制导管抽吸阻力无变化,管腔堵塞0例(0%),两组比较有显著性差异(P0.01)。声门下分泌物:市售导管组(16.55±8.66)mL/d,自制导管组(40.12±25.48)mL/d,两组比较差异无统计学意义(P0.05)。手术切口感染率:普通导管组5例(50%),市售导管组2例(28%),自制导管组2例(15%),三组间比较有显著差异(P0.01)。气囊充气后以直尺实物测量冲洗管背侧边缘与气囊背侧边缘的距离为2~4 mm。结论自制可冲洗气管导管可有效清除声门下分泌物,不会压迫患者气管壁,安全可靠,价格便宜。

Clinical Application of Self-Made Washable Endotracheal Tube for Subglottic Secretion Drainage

Objective To explore the effectiveness and safety of self-made washable endotracheal tube for subglottic secretion drainage.Methods Ordinary endotracheal tube and sputum aspirating tubes were used to make washable endotracheal tube for subglottic secretion drainage in our hospital.The self-made tubes were compared with washable endotracheal tube available on the market.The suction resistance,the cases of obstruction in the tubes,the average daily drainage,and the cases of infection of incisional wound were compared between the two kinds of tubes,and their safety was evaluated.Results After three days of application,the suction resistance of endotracheal tube available on the market increased,with six cases of the blockage of the lumen（85%）,while that of self-made endotracheal tube did not change,with no cases of blockage（0%）.There was significant difference between these two kinds of tubes（P〈0.01）.The average daily drainage in the former was（16.55±8.66）mL/d;while that in the latter was（40.12±25.48）mL/d.There was no significant statistical difference between the two kinds of tubes（P〈0.05）.The incidence of infection of incisional wound in the ordinary endotracheal tube was 50%（5 cases）;that in the tubes available on the market was 28%（2 cases）;that in the self-made tubes was 15%（2 cases）.There was significant difference among the three groups.When tube cuffs were inflated,the distance between the back edge of suction tubes and tube cuffs was was 2-4 mm.Conclusion Self-made washable endotracheal tubes are effective for subglottic secretion drainage with good safety and low price.