老年患者气管切开术后并发症的原因分析与护理

目的探讨老年患者气管切开术后并发症的危险因素和护理对策。方法回顾性分析1996—2006年10月60例65～95岁行气管切开术的老年患者的病例资料,采用Logistic回归方法对可能导致并发症的13个临床因素进行分析,并提出了针对性的护理措施。结果本组患者发生术后并发症30例(50.0%),常见的并发症为伤口感染20例(33.3%)、出血10例(16.7%)、皮下气肿8例(13.3%),少见并发症为套管堵塞2例(3.3%)、气管软化2例(3.3%)、气管食管瘘2例(3.3%)、脱管1例(1.7%)。结论并发症相关危险因素有多器官功能衰竭、凝血障碍、高龄、糖尿病和置管时间过长等。根据其相关危险因素采取针对性的治疗、护理措施,可减少老年患者气管切开手术后的并发症。

Complication after Tracheostomy in Elderly Patients:Analysis of Risk Factors and Nursing Strategy

Objective To explore the risk factors and nursing strategy of tracheostomy complica- tions in elderly patients.Methods The clinical data of 60 elder patients who received tracheosto- mies during January 1996 to October 2006(aged 65 to 95 years)were retrospectively analyzed. Thirteen risk factors of the complications were studied with logistic regression analysis.Results Complications were observed in 30(50.0%)patients after operation.The most common compli- cation was incision infection(20 patients,33.2%);hemorrhage ranked the second(10 patients, 16.6%);subcutaneous edema was seen in 8 patients(13.4%).The major risk factors for compli- cations were the MODF,coagulation disturbance,diabetes,older age and long-term tracheosto- my.Conclusion Individual treatment and nursing intervention should be given to patients after tracheostomy to reduce complications.