机械通气时气管套管致气管食管瘘的原因分析和预防措施探讨

目的探讨机械通气患者气管切开套管引起气管食管瘘的原因及其预防措施。方法结合5例气管切开套管导致气管食管瘘的机械通气患者临床资料和相关文献复习,详细分析其病因和预防措施。结果机械通气患者发生气管食管瘘与气囊压力过高、气囊压迫时间过长、呼吸机管道重力压迫气管后壁、套管不稳定活动增多、气管切开破坏了气管的结构和稳定性等因素有关,预防措施主要是常规监测气囊内压、避免压力过高、妥善固定气管套管、减轻呼吸机管道对气管后壁的压迫、躁动病人适当镇静等。结论加强机械通气患者人工气道与气囊的管理,能最大限度减轻气管内膜机械性损伤,降低气管食管瘘的发生率。

Reasons and preventive measures on tracheoesophageal fistula caused by endotracheal tube in mechanical ventilation

Objective To explore the reasons and preventive measures on tracheoesophageal fistula caused by endotracheal tube in mechanical ventilation.Methods Based on the 5-case report and a review of relevant literatures,the reasons and preventive measures were described.Results Tracheoesophageal fistula might be caused by higher cuff pressure,long time of cuff oppression,oppression on tracheal wall by ventilator pipe,instable activities of endotracheal tube,damage of tracheal structure and stability.Main preventive...