ICU气管切开鼻饲病人误吸的护理干预
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摘要
ICU患者病情危重,分解代谢亢进,能量需要增加,为保证危重病人的营养供给,必须通过留置胃管鼻饲给予营养支持。长期留置鼻饲管的气管切开患者,因咽部受到气管导管气囊和鼻饲管的压迫,加上反复刺激,环状括约肌不同程度损伤及功能障碍,增加了返流误吸的发生。一旦诊断误吸,应鼓励或诱发咳嗽,吸净气道、口腔、鼻腔内分泌物,必要时可用纤维支气管镜吸出分泌物,同时加强抗生素的使用,防止肺炎和肺脓肿的发生[1]。
ICU patients in a critical condition, the decomposition hypermetabolism, need to increase energy, to ensure the nutrition of critically ill patients, must through the indwelling gastric tubenasogastric nutrition support. Tracheotomy patients with nasogastric tube for a long time, because of the pharyngeal oppression by tracheal catheter gasbag and nasogastric tube, and repeated stimulation, circular sphincter injury and dysfunction, different level increased regurgitation aspiration. Once the diagnosis of aspiration, or induced cough, should be encouraged to absorb net airway, oral, nasalsecretions, fiber bronchoscope and epispastic secretions if necessary, at the same time to strengthen the use of antibiotics, prevent the occurrence of pneumonia and pulmonary abscess [1].
引文
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