小儿气管切开术患者的家庭护理经验。

J B Campbell, D W Morgan, K Pearman
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引用次数: 3

摘要

许多气管切开术后的婴儿仍长时间插管,而气道阻塞的根本原因要么得到治疗,要么等待自然解决(通常是通过生长)。为了使这些孩子在气管切开术后仍能享受一个相对正常的家庭环境,他们至少有一部分时间应该在家里接受治疗。在过去的8年里,我们在患者中常规使用软聚氯乙烯儿科气管切开术管(希利)。这些导管已被证明对分泌物阻塞具有相对的抵抗力,每隔1至2周更换一次。它们可以通过在肩部周围制作一系列3到4个2毫米的穿透式开窗来进行修改,以改善语音产生并促进去环形。指导家长进行气管切开术护理,包括换管、加湿和吸痰。当他们被认为有能力时,就允许他们把孩子从医院接回家。28名儿童(13名男孩,15名女孩)在气管切开术时平均年龄为14.5周(范围1-525周),在家中使用该系统进行管理。住院治疗的中位时间为12周(范围5-75周),家庭管理的中位时间为94周(范围13-394周)。16名患者已成功摘除导管,11名患者仍未摘除导管,1名患者因婴儿猝死综合征在家中死亡。尽管采取了支持措施,大多数儿童还是出现了间歇性胸部感染。(摘要删节250字)
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Experience with the home-care of tracheotomised paediatric patients.

Many infants with tracheotomies remain cannulated for prolonged periods while the underlying cause of airway obstruction is either treated or natural resolution is awaited (usually by growth). To enable these children to enjoy a relatively normal family environment despite a tracheotomy, it is desirable that they should be managed at home for at least part of the time. For the past 8 years we have routinely used soft polyvinyl chloride paediatric tracheotomy tubes (Shiley) in our patients. These tubes have proved to be relatively resistant to obstruction with secretions and are changed at 1- to 2-week intervals. They can be modified by making a series of three to four 2-mm through-and-through fenestrations around the shoulder in order to improve speech production and facilitate decannulation. Parents are tutored in tracheotomy care, which includes tube changing, humidification and suction. They are then permitted to take their child home from hospital when they are considered to be competent. Twenty-eight children (13 boys, 15 girls) with a mean age of 14.5 weeks (range 1-525 weeks) at the time of tracheotomy have been managed at home using this system. The median period of hospitalisation was 12 weeks (range 5-75 weeks), and the median duration of home management was 94 weeks (range 13-394 weeks). Sixteen patients have been successfully decannulated, 11 remain cannulated and 1 died at home from sudden infant death syndrome. Despite supportive measures, the majority of the children developed intermittent chest infections.(ABSTRACT TRUNCATED AT 250 WORDS)

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