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重型颅脑损伤病人短期内不能清醒,且咳嗽及吞咽反射减弱或消失,气管内分泌物增多等会导致气道不通畅,引起脑供血不足等加重病情,为确保患者呼吸道通畅,改善脑缺氧,减轻脑水肿,常需行气管切开术,以加强气道护理。气管切开后气道改变原来途径,失去湿化作用,分泌物干结,排痰不畅,影响呼吸功能,易造成病原菌侵入,肺部感染率亦随气道湿化程度的降低而升高,因而充分湿化气道是保持气管切开术后呼吸道通畅和防止肺部感染的关键之一。临床上对气道的湿化方法很多,效果不一,我院对2004～2007年因重型颅脑损伤而行气管切开的病人行不同方式气道湿化,进行研究,现报告如下。
Patients with severe craniocerebral injury in the short term can not be awake, and cough and swallowing reflexes weakened or disappeared, increased endotracheal secretions will lead to airway is not smooth, causing insufficient blood supply to the brain aggravate the condition, to ensure that patients with airway patency and improve cerebral hypoxia, Reduce cerebral edema, often require tracheotomy, to enhance airway care. Tracheotomy airway to change the original way, loss of humidification, secretions dry end, expectoration sputum, affecting respiratory function, easy to cause invasion of pathogens, lung infection rate also increased with the degree of airway humidification decreased, Therefore, fully humidified airway is to maintain tracheostomy airway patency and prevent lung infection is one of the keys. Clinical wet airway many ways, the effect is different, our hospital for 2004 to 2007 due to severe craniocerebral tracheotomy patients with different ways of wet airway, the study is as follows.