气管切开一次性拔管与试堵管后拔管的比较研究

目的 探讨气管切开患者一次性拔管的可行性。方法 把气管切开的患者按投币的方式髓机分为一次性拔管组和试堵管后拔管组，在拔管适应症下给予一次性拔管或试堵管后拔管，观察病人胸闷、咳嗽、呼吸困难等情况，记录拔管和试堵管过程及天数。结果 一次性拔管全部成功，拔管后无明显的不适和呼吸困难，试堵管组在半堵时对呼吸影响不大，但在全堵时大部分出现明显的胸闷、咳嗽和呼吸困难，甚至出现拔管困难，有的在半堵或2／3堵的情况下给以拔管，试堵管天数平均4．8d。结论 气管切开的病人有拔管适应症时，一次性拔管符合病人的生理特点，如果试堵管，只能半堵或2／3堵，不宜全堵。

Comparative study on the tube drawing by only one time tracheotomy and tuber drawing after tuber obstruction

Objective To study the possibility of tuber drawing by only time tracheotomy. Method Patients with tracheotomy were randomly divided into group of tuber drawing by only time tracheotomy and group of tuber drawing after tuber obstruction. Under adaptive condition, tuber drawing was conducted, and uncomfortable, cough, chest distress and dyspnea after tuber drawing between the two group were observed, the time and process of drawing were recorded. Results All of the tuber drawing by only time tracheotomy were succeeded. No cough, chest distress and dyspnea after tuber drawing were found. In group of tuber drawing after tuber obstruction, most patients has cough, chest distress and dyspnea after tuber total obstructed. Some tuber drawing conducted during tuber half obstructed or 2/3 obstructed. The mean longs of tuber obstruction were 4.8 days. Conclusion When the adaptive condition of tuber drawing for patients with tracheotomy appeared, tuber drawing by only time was suitable for patients' physical characteristic, the tuber drawing should be conducted when the tuber was half or 2/3 obstructed.