脑损伤气切患者拔管前评估及康复治疗进展
Progress of Assessment and Rehabilitation Treatment before Extubation in Patients with Tracheotomy of Brain Injury
DOI: 10.12677/ACM.2024.142341, PDF,   
作者: 韩 啸, 王宝兰*:新疆医科大学第一附属医院康复医学科,新疆 乌鲁木齐
关键词: 脑损伤气管切开评估康复拔管Brain Injury Tracheotomy Evaluation Rehabilitation Decannulation
摘要: 气管切开术是抢救重症脑损伤患者生命的重要手段,但长期留置气管套管易使患者发生各种并发症,早期评估危险因素以及康复治疗有利于患者早期安全拔管,本文就脑损伤气切患者拔管前评估及康复治疗进行如下综述。
Abstract: Tracheotomy is an important means to save the life of patients with severe brain injury, but long- term tracheotomy with indwelling tube is easy to cause various complications in patients. Early evaluation of risk factors and rehabilitation treatment are conducive to early and safe extubation of patients. This article reviews the evaluation and rehabilitation treatment before extubation in pa-tients with severe brain injury tracheotomy.
文章引用:韩啸, 王宝兰. 脑损伤气切患者拔管前评估及康复治疗进展[J]. 临床医学进展, 2024, 14(2): 2434-2439. https://doi.org/10.12677/ACM.2024.142341

参考文献

[1] Trouillet, J.L., Collange, O., Belafia, F., et al. (2018) Tracheotomy in the Intensive Care Unit: Guidelines from a French Expert Panel. Annals of Intensive Care, 8, Article No. 37. [Google Scholar] [CrossRef] [PubMed]
[2] Mortensen, J., Kjeldsen, S.S., Honoré, H., et al. (2020) Using Routinely Gathered Clinical Data to Develop a Prognostic Online Tool for Decannulation in Subjects with Acquired Brain Injury. Respiratory Care, 65, 1678-1686. [Google Scholar] [CrossRef] [PubMed]
[3] 刘丰年. 颅脑外伤及脑出血患者气管切开后拔管时机与方法[J]. 医学理论与实践, 2007, 20(11): 1282-1283.
[4] 徐爱花. 气管切开套管拔管前堵管的可行性分析[J]. 中国误诊学杂志, 2012, 12(12): 2855.
[5] 郑景森, 盛志春, 唐永红, 等. 肺康复运动对留置气管套管患者生活质量及肺功能的影响[J]. 中国实用医药, 2020, 15(10): 185-187.
[6] 陈琼梅, 霍建珊. 气管切开病人拔管的规范性护理[J]. 全科护理, 2012, 10(22): 2059-2060.
[7] Budweiser, S., Baur, T., Jörres, R.A., et al. (2012) Predictors of Successful Decannulation Using a Tracheostomy Retainer in Patients with Prolonged Weaning and Persisting Respiratory Failure. Respiration, 84, 469-476. [Google Scholar] [CrossRef] [PubMed]
[8] 倪军喜, 方晨光, 李毅. 急危重气管切开患者拔管失败的临床特点分析[J]. 中国中西医结合急救杂志, 2017, 24(6): 608-612.
[9] Perin, C., Meroni, R., Rega, V., et al. (2017) Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after Severe Acquired Brain Injury (sA-BI). International Archives of Otorhinolaryngology, 21, 382-389. [Google Scholar] [CrossRef] [PubMed]
[10] Hakiki, B., Draghi, F., Pancani, S., et al. (2020) Decannulation after a Severe Acquired Brain Injury. Archives of Physical Medicine and Rehabilitation, 101, 1906-1913. [Google Scholar] [CrossRef] [PubMed]
[11] Higashi, T., Eguchi, H., Wakayama, Y., et al. (2019) Analysis of the Risk Factors for Tracheostomy and Decannulation after Traumatic Cervical Spinal Cord Injury in an Aging Popula-tion. Spinal Cord, 57, 843-849. [Google Scholar] [CrossRef] [PubMed]
[12] 卢昌均, 安红伟, 韦冰心. 神经危重症气管切开患者拔除气管插管影响因素研究[J]. 临床和实验医学杂志, 2014(12): 976-979.
[13] Enrichi, C., Battel, I., Zanetti, C., et al. (2017) Clinical Criteria for Tracheostomy Decannulation in Subjects with Acquired Brain Injury. Respiratory Care, 62, 1255-1263. [Google Scholar] [CrossRef] [PubMed]
[14] Park, C., Ko, R.E., Jung, J., et al. (2021) Prediction of Successful De-Cannulation of Tracheostomised Patients in Medical Intensive Care Units. Respiratory Research, 22, Ar-ticle No. 131. [Google Scholar] [CrossRef] [PubMed]
[15] Chang, A.T., Boots, R.J., Brown, M.G., et al. (2005) Reduced Inspiratory Muscle Endurance Following Successful Weaning from Prolonged Mechanical Ventilation. Chest, 128, 553-559. [Google Scholar] [CrossRef
[16] Bach, J.R. and Saporito, L.R. (1994) Indications and Criteria for Decannulation and Transition from Invasive to Noninvasive Long-Term Ventilatory Support. Respiratory Care, 39, 515-531.
[17] Bach, J.R. and Saporito, L.R. (1996) Criteria for Extubation and Tracheostomy Tube Removal for Patients with Ventilatory Failure. A Different Approach to Weaning. Chest, 110, 1566-1571. [Google Scholar] [CrossRef] [PubMed]
[18] 周君桂, 吴红瑛, 李苑媚, 等. 染料试验在重症康复病房气管切开患者误吸筛查中的应用[J]. 中国康复医学杂志, 2018, 33(3): 337-340.
[19] 黄妍, 张军, 安旭, 等. 纤维鼻咽喉镜吞咽功能检查对脑卒中气管切开拔管指征的指导意义[J]. 中华保健医学杂志, 2019, 21(6): 568-569, 583.
[20] Liu, I.Y., Mendelsohn, A.H., Ching, H., et al. (2015) Staged Laryngotracheoplasty in Adult Laryngotracheal Stenosis: Predictors of Long-Term Decannulation. JAMA Otolaryngology—Head & Neck Surgery, 141, 211-218. [Google Scholar] [CrossRef] [PubMed]
[21] Santus, P., Gramegna, A., Radovanovic, D., et al. (2014) A Sys-tematic Review on Tracheostomy Decannulation: A Proposal of a Quantitative Semiquantitative Clinical Score. BMC Pulmonary Medicine, 14, Article No. 201. [Google Scholar] [CrossRef] [PubMed]
[22] 青刚, 黄万秀. 气管切开后拔管困难原因分析及处理[J]. 中国内镜杂志, 2017, 23(1): 90-94.
[23] 吴旋, 苏振忠, 蒋爱云, 等. 成人气管切开机械通气并发气管狭窄的相关因素分析[J]. 中山大学学报(医学科学版), 2005, 26(6): 714-717.
[24] 呼格吉乐图, 艾冬雪, 张晓敏, 等. 气道廓清技术在重型颅脑损伤昏迷患者肺康复中的应用[J]. 中国康复, 2022, 37(8): 473-476.
[25] 刘翠, 甄巧霞, 齐琳, 等. 主动循环呼吸技术在脑卒中相关性肺炎气管切开患者治疗中的临床价值研究[J]. 中国医学装备, 2022, 19(4): 114-117.
[26] 朱秀华, 朱永刚, 王银龙, 等. 体外膈肌起搏器联合呼吸训练对脑卒中气管切开患者肺功能的影响[J]. 中国康复医学杂志, 2021, 36(8): 973-977.
[27] Pozuelo-Carrascosa, D.P., Cobo-Cuenca, A.I., Carmona-Torres, J.M., et al. (2022) Body Position for Preventing Ventilator-Associated Pneumonia for Critically Ill Patients: A Systematic Review and Network Meta-Analysis. Journal of Intensive Care, 10, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[28] Katz, S., Arish, N., Rokach, A., et al. (2018) The Effect of Body Position on Pulmonary Function: A Systematic Review. BMC Pulmonary Medicine, 18, Article No. 159. [Google Scholar] [CrossRef] [PubMed]
[29] 龙耀斌. 电动站立床在气管切开患者体位排痰中的应用效果[J]. 中国康复医学杂志, 2013, 28(1): 69-70. [Google Scholar] [CrossRef
[30] 王亚玲, 张艳, 董晓玲. 物理振动结合起立床体位排痰对肺部耐药菌感染患者的影响[J]. 齐鲁护理杂志, 2016, 22(21): 92-93. [Google Scholar] [CrossRef
[31] Zivi, I., Valsecchi, R., Maestri, R., et al. (2018) Early Rehabilitation Reduces Time to Decannulation in Patients with Severe Acquired Brain Injury: A Retrospective Study. Frontiers in Neurology, 9, Article No. 559. [Google Scholar] [CrossRef] [PubMed]
[32] Wang, T.H., Wu, C.P. and Wang, L.Y. (2018) Chest Physiotherapy with Early Mobilization May Improve Extubation Outcome in Critically Ill Patients in the Intensive Care Units. The Clin-ical Respiratory Journal, 12, 2613-2621. [Google Scholar] [CrossRef] [PubMed]
[33] 谢晓燕, 程元, 程贤琴, 等. 早期吞咽功能训练对脑卒中气管切开患者快速康复的影响[J]. 昆明医科大学学报, 2019, 40(5): 122-125.
[34] Gregoretti, C. and Pisani, L. (2015) Tracheost-omy, Swallowing Disorders and Rehabilitation: It Is Never Too Late. Minerva Anestesiologica, 81, 357-359.
[35] 王丹阳, 王留根, 杨俊锋, 等. 间歇经口至食管管饲法在脑出血后气管切开患者中的临床应用[J]. 中华物理医学与康复杂志, 2022, 44(12): 1079-1083.
[36] 窦祖林, 万桂芳, 谢纯清, 等. 吞咽说话瓣膜在气管切开吞咽障碍患儿中的应用[J]. 中华物理医学与康复杂志, 2011, 33(12): 906-908.
[37] O’Connor, L.R., Morris, N.R. and Paratz, J. (2019) Physiological and Clinical Outcomes Associated with Use of One-Way Speaking Valves on Tracheostomised Pa-tients: A Systematic Review. Heart & Lung, 48, 356-364. [Google Scholar] [CrossRef] [PubMed]
[38] Lichtman, S.W., Birnbaum, I.L., Sanfilippo, M.R., et al. (1995) Effect of a Tracheostomy Speaking Valve on Secretions, Arterial Oxygenation, and Olfaction: A Quantitative Evaluation. Journal of Speech and Hearing Research, 38, 549-555. [Google Scholar] [CrossRef] [PubMed]
[39] Dziewas, R., Stellato, R., Van Der Tweel, I., et al. (2018) Pharyngeal Electrical Stimulation for Early Decannulation in Tracheotomised Patients with Neurogenic Dysphagia after Stroke (PHAST-TRAC): A Prospective, Single-Blinded, Randomised Trial. The Lancet Neurology, 17, 849-859. [Google Scholar] [CrossRef
[40] Suntrup, S., Marian, T., Schröder, J.B., et al. (2015) Electrical Pharyngeal Stimulation for Dysphagia Treatment in Tracheotomized Stroke Pa-tients: A Randomized Controlled Trial. Intensive Care Medicine, 41, 1629-1637. [Google Scholar] [CrossRef] [PubMed]