插管后气管狭窄的临床研究.pdf

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1、授予单位代码10089学号或申请号13236对处(E搿大迳HebeiMedicalUniversity插管后气管狭窄的临床研究学位申请人：贡瑞霞导师：蔡志刚教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用••凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责

2、任。研究生签名：曼导师签章二级学院领导盖章：年河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名:导师签章:一士年《月公日目录中文摘要················································································1英文摘要········································

3、········································4研究论文插管后气管狭窄的临床研究前言···············································································8资料与方法······································································8结果··································································

4、···········10附图·············································································12附表·············································································13讨论·············································································14结论·························

5、····················································22参考文献·······································································22综述气囊压力与气管狭窄的研究进展·······································25致谢····················································································30个人简历···

6、···········································································31中文摘要插管后气管狭窄的临床研究摘要目的：调查用高容低压气管插管后，不同方法监测气囊压力对气管狭窄的影响，观察插管后气管狭窄的发病率，分析产生气管狭窄的原因，探讨如何减少甚至避免气管狭窄的发生。方法：1选2014年1月至2015年1月间河北医科大学第二医院呼吸ICU、麻醉ICU、急诊ICU及衡水市第四人民医院重症监护室患者120例，年龄在18-70岁，他们均因不同原因需行气管插管，有创机械通气治疗，均应用高容

7、低压气管插管，并成功拔管的患者。所有入选者分为观察组（河北医科大学第二医院呼吸ICU和急诊ICU）及对照组（麻醉ICU和衡水市第四人民医院重症监护室），两组患者从病种、年龄、性别等方面无明显差异。在日常工作中，观察组自患者气管插管后常规用气囊压力表监测并调整气囊压力，每8小时一次，保证气囊压力在25-30cmH2O之间。对照组用手捏气囊感觉法，通过手指触摸感受气管插管近端气囊张力，完全凭经验给气囊注气，估计并调整气囊压力在正常范围内。护理人员从吸痰等相关护理方面进行了统一培训。1.1试验中专人用测压表监测两组患者的气囊压力。患者取半卧位，应用气管导管气囊压力测

8、量仪监测气囊压力，单位用cmH2O表示