神经外科气管切开术后套管阻塞原因分析与护理对策家庭护士2008年7刀第6卷第7期下旬版(总第114期)71891?质量的基础上，通过制定标准的治疗，护理疗程，界定了标准的住院口,控制和规范各项费用并宣教病人每日的功能锻炼方法，从而尽量地缩短了住院日，降低了住院费用•从表2,表3可以看出:对照组与实验组病人在住院日和住院费用上存在明显差别.实验组病人的平均住院H和住院费用均明显低于对照组,说明临床路径管理模式确实可以优化护理程序，有效利用医疗资源，降低住院费用,缩短住院周期•另外在医疗护理质量，病人满意度及其医院竞争力方面也有明显的提升.参考文献：[1]林碧珠，琴英，陆嘉玲，等•临床路径在骨科Z应用EJ].台湾护理杂志,1988,46(2):45—53.[21HofmannPA.Criticalpathmethod:Animportanttoolforcoordi一natingclinicalcare[J].JoumalonQualityImprovement,1993J9(7):235—246.[3]杨桂涛.临床护理路径EJ].国外医学护理学分册,1998,17(1):1.[4]刘淑敏，马晓燕.临床路径在椎间盘镜治疗腰椎间盘突出症中的应用EJ].中华护理杂志,2005,40(4):273—274.作者简介曹嗣菊，林海英,李丹工作单位：421001,南华大学附属第一医院.(收稿口期:2008—05—27)(本文编辑郭海瑞)神经外科气管切开术后套管阻塞原因分析与护理对策Causativeanalysisofcannulablockageforpatientsafter?tracheotomyindepartmentofneurosurgeryanditsnursingstrategies姚明兰YaoMinglanCGuidongPeople^HospitalofWuzhouCityGuangxiZhuangNationalityAutc?nomousRegion,Guangxi543001China)摘要:［目的］探讨神经外科行气管切开术后病人套管阻塞的原因，采取相应措施,使气管切开套管阻塞发生率降低•［方法］回顾性分析近8年本科行气管切开术后发生气管套管阻塞52例，占气管切开病人数7.41,通过湿化气道，适时吸痰，早期雾化吸入和改良吸氧，同时避免气囊套管长期过度充气，加I强吸痰技术培训，早期发现阻塞的表现，及时处理半阻管40例，全阻管12例」结果］均能及吋发现，给予相应对症处理,保持了呼吸道通畅,无一例因套管阻塞而引起死亡的病例•［结论］及早了解气管切开术后病人的病情,了解痰液的性质和量，给予早期湿化气道，适吋吸痰和套管气囊适度充气,出现大出血者立即做好手术准备等一系列预见性的护理措施,对减少病人术后气管套管阻塞有十分重要意义.关键词:神经外科;气管切开;阻塞护理AbstractObjective:ToprobeintothecausesofcannulablockageofpatientsafterundergoingtracheotomyindepartmentofneurosurgerySOastomini一mizetheincidenceofcannulablockage.Methods:Atotalof52patientsOC—curredcannulablockageaftertracheotomyinrecenteightyearswereana---------lyzedretrospectively.Itaccountedto7.41ofpatientsundergoingtrache一otomy.Method:Atotalof701patientsundergoingtracheotomyinourde一partmentinrecenteightyearswereanalyzedretrospectively.And52casesofthemdevelopedcannulablockage,accountingfor7.41ofthetotaltrache—otomypatients.Amongthem,40casesdevelopedhalf—blockageandl2ca一sesdevelopedcompleteblockage.Andbyhumifyingtrachea.sputumaspira一tion,atomizingnebulizationandmodifiedoxygeninhalation,meanwhile,a一voidingthetrachealtrocarlongtermover--------inflationandstrengtheningspu一tumaspirationskillstraining.findingthemanifestationofblockageintime,allthesecaseshadbeenhandledontime>Resuhs:A11patientswithcannulablockagewerefoundintime.Therewerenodeadcasesbecauseofcorre一spondingtreatmenttokeeprespiratorytractunobstructed.Conclusion:Itwasquitesignificantbyconductingaseriesofpredictivenursingmeasurestodecreasepostoperativecannulablockage,suchastounderstandthepatientSconditionassoonaspossibleandthequantityandqualityofsputumnSOastohumifytrachea,sputumaspirationanddoingaerocystaerationearly,timelyandmoderately;toprep一areoperationwellforhemorrhoeapatientsimmedi—ately.Keywordsneurosurgerytracheotom...