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报告20例气管内插管呼吸支持抢救重危、呼衰病人的经验。作者强调要经血气分析,调整呼吸器各项参数,使PaO_2和PaCO_2维持在满意水平。无创氧饱和度监测能反映病人每瞬间的氧合和心率情况。长期置管者需选用氯化聚乙烯塑料导管,质地柔软并有低压高容的套囊,导管内径女性<7.5mm,男性<8.5mm为宜。作者认为,如插管已超过10天,而病情估计仍需要作长期呼吸支持者,应改气管造口。在机械呼吸治疗过程中必须加强湿化和分泌物的清除,遇有导管滑出时,切莫盲目推进导管,以免误入食管。
Report 20 cases of endotracheal intubation respiratory support rescue critically ill patients with respiratory failure experience. The authors emphasize that blood gas analysis, adjust the parameters of the respirator, PaO_2 and PaCO_2 maintained at a satisfactory level. Non-invasive oxygen saturation monitoring can reflect the patient’s oxygenation and heart rate each moment. Long-term catheterization need to use chlorinated polyethylene plastic catheter, soft texture and low pressure and high volume cuff, catheter diameter female <7.5mm, male <8.5mm is appropriate. The author believes that if the intubation has been more than 10 days, and the condition is still estimated need for long-term respiratory support, should be changed tracheostomy. In the mechanical respiratory therapy must strengthen the humidification and removal of secretions in case of catheter slide out, do not blindly advance the catheter, so as not to fall into the esophagus.