口腔医学研究

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (1): 35-39.DOI: 10.13701/j.cnki.kqyxyj.2024.01.007

• 口腔颌面外科学研究 • 上一篇    下一篇

不同类型气管套管联合自制堵管对气管切开术后并发症的临床分析

李审绥1, 田旭东1, 王伟丽2*, 唐正龙1*   

  1. 1.贵州医科大学附属口腔医院口腔颌面外科 贵州 贵阳 550004;
    2.贵州医科大学附属医院血液科 贵州 贵阳 550004
  • 收稿日期:2023-08-25 出版日期:2024-01-28 发布日期:2024-01-22
  • 通讯作者: *王伟丽,E-mail:weili533@163.com 唐正龙,E-mail:tangzhenglong@hotmail.com
  • 作者简介:李审绥(1994~ ),男,贵州毕节人,硕士,主治医师,主要从事口腔颌面外科的临床基础研究。
  • 基金资助:
    贵州省卫生健康委科学技术基金项目(编号:2024GZWJKJXM0294)贵州医科大学附属口腔医院横向课题基金(编号:GYKQ2022HXZD05)贵州医科大学附属口腔医院科研基金(编号:GYKQKY202305)贵州医科大学本科教学改革研究课题-重点项目基金(编号:JG2023017)

Clinical Analysis of Different Types of Tracheal Cannulas Combined with Self-made Blockage Tubes for Postoperative Complications after Tracheotomy

LI Shensui1, TIAN Xudong1, WANG Weili2*, TANG Zhenglong1*   

  1. 1. Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Guizhou Medical University, Guiyang 550004, China;
    2. Department of Pharmacy, Guizhou Medical University, Guiyang 550004, China
  • Received:2023-08-25 Online:2024-01-28 Published:2024-01-22

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摘要： 目的:探讨口腔颌面部患者使用带气囊套管、金属气管套管联合自制堵管对气切后并发症的临床分析。方法:研究对象选择2020年6月~2023年8月在贵州医科大学附属口腔医院口腔颌面外科行气管切开的100例患者,随机分组,对其进行临床资料的回顾性分析,将患者分为带气囊套管组(47例)和气囊套管+金属套管组(53例),两组均使用自制堵管,统计临床资料、住院时间、术后并发症以及术后肺炎的临床分析、治疗方法、致病菌,总结气切后发生肺炎的相关因素进行统计分析。结果:在气管切开术后,术后肺炎发生率为36.00%。气囊组相比于气囊+金属组,发生率为2.12%(P<0.0001),出血发生率为1%,皮下气肿1%。气囊组未出现脱管,而气囊+金属组脱管发生率为20%。所有患者未出现呼吸困难,拔管困难及气管食管瘘。此外单因素分析结果显示有吸烟史及饮酒史的患者在气管切开术后发生肺炎的发生率高,具有统计学意义(P<0.05)。Logistic回归分析发现拔气管套管时间的长短及气管套管类型是气切后发生肺炎的综合危险因素(OR=0.021,95%CI:0.002~0.19,P<0.0001)。结论:在口腔颌面部患者行气管切开术后,常规使用气囊套管联合自制堵管,可减少患者住院时间,降低术后并发症及肺炎的发生。

关键词: 气管切开, 气管套管, 肺炎, 自制堵管, 并发症

Abstract: Objective: To explore the clinical analysis of complications after gas resection in oral and maxillofacial patients using a combination of balloon cannula, metal tracheal cannula, and self-made blockage tube. Methods: The study subjects selected 100 patients who underwent oral and maxillofacial tracheostomy at the Affiliated Stomatological Hospital of Guizhou Medical University from June 2020 to August 2023, and conducted a retrospective analysis of their clinical data. The patients were randomly divided into a group with airbag cannula (47 cases) and a group with airbag cannula and metal cannula (53 cases). Both groups were combined with self-made cannulas. Clinical data, hospitalization time, clinical analysis, treatment methods, pathogenic bacteria of postoperative complications and pneumonia, and relevant factors for pneumonia after gas resection were analyzed. Results: After tracheotomy, the incidence of postoperative pneumonia was 36.00%. Compared with the airbag+metal group, the incidence rate of the airbag group was 2.12% (P<0.001), the incidence of bleeding was 1%, and subcutaneous emphysema was 1%. The airbag group did not experience tube detachment, while the incidence of tube detachment in the airbag+metal group was 20%. All patients did not experience breathing difficulties, difficulty in extubation, or tracheoesophageal fistula. In addition, the results of univariate analysis showed that patients with smoking history, and drinking history had a higher incidence of pneumonia after tracheotomy, which was statistically significant (P<0.05). Logistic regression analysis found that the duration of tracheal cannula removal and the type of tracheal cannula were comprehensive risk factors for pneumonia after gas resection (OR=0.021, 95%CI:0.002-0.19, P<0.001). Conclusion: After tracheotomy in oral and maxillofacial patients, the routine use of balloon cannula combined with self-made blockage tube can reduce patient hospitalization time, postoperative complications, and the occurrence of pneumonia.

Key words: tracheotomy, tracheal tube, pneumonia, self-restraint pipe plugging, complication