[医学]气 管 插 管 术

《[医学]气 管 插 管 术》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、气管插管术新疆医科大学第一附属医院麻醉科Contents定义及概述1适应症及禁忌症2操作3并发症4www.themegallery.comCompanyLogo定义Definition气管插管术是一种将一特制的气管内导管经声门置入气管的技术，这一技术能为气道通畅、通气供氧、呼吸道吸引和防止误吸提供最佳条件。Theinsertionofatubeintothetracheatoallowairtoenterthelungs.www.themegallery.comCompanyLogo呼吸道解剖Anatomy气管插管的途径是通过鼻腔或口腔，经过咽喉、声门、

2、把插管插到气管或总支气管内。www.themegallery.comCompanyLogowww.themegallery.comCompanyLogo适应症Indications心跳、呼吸骤停。Cardiacorrespiratoryarrest丧失气道保护功能者。Failuretoprotecttheairway严重呼吸衰竭不能满足机体通气和氧供需要需机械通气者。Inadequateoxygenationorventilationwww.themegallery.comCompanyLogo适应症Indications即将发生或已发生的气道阻塞Imp

3、endingorexistingairwayobstruction多系统疾病或损伤的护理需要。Careofcriticallyillpatientswithmulti-systemdiseaseorinjuries.外科手术麻醉需要。Controloftheairwayinsurgicalproceduresrequiringgeneralanesthesia.www.themegallery.comCompanyLogo禁忌症Contraindications无绝对禁忌症，以下所列为相对禁忌症。由于外部原因所致上气道梗阻Obstructionofthe

4、upperairwayduetoforeignobjects颈椎骨折Cervicalfractures食道疾病Esophagealdisease进食腐蚀性物质Ingestionofcausticsubstances下颚骨折Mandibularfractures喉头水肿Laryngealedema烫伤或化学药剂灼伤Thermalorchemicalburnswww.themegallery.comCompanyLogo插管前准备Equipmentpreparation1.气管导管导管的选择Sizeofendotrachealtube按导管的内径计算inte

5、rnaldiameter(ID)男性Male:ID8.0mms女性Female:ID7.5mmswww.themegallery.comCompanyLogo插管前准备Equipmentpreparation儿童的导管选择Sizeofendotrachealtube0-3月（Newborn-3months）:ID3.0mm3-9月（3-9months）:ID3.5mm9-18月（9-18months）:ID4.0mms2-6岁（2-6years）:ID=(Age/3)+3.5>6岁（>6years）:ID=(Age/4)+4.5www.themegall

6、ery.comCompanyLogo插管前准备Equipmentpreparation插管深度Depthofendotrachealtube成人Adult男性Male=23cms女性Female=21cms儿童Children经口气管插管=(Age/2)+12(cm)经鼻气管插管=(Age/2)+15(cm)www.themegallery.comCompanyLogo插管前准备Equipmentpreparation2.喉镜Laryngoscope气管插管使用的为直接喉镜。直接喉镜分直镜（miller）和弯镜（macintosh）两种。www.them

7、egallery.comCompanyLogo插管前准备Equipmentpreparation操作前务必检查喉镜是否明亮www.themegallery.comCompanyLogo插管前准备Equipmentpreparation其他Otherequipments导丝Stylet手套Gloves吸痰器SuctionDevice5ML注射器syringe固定器Endotrachealtubeholderwww.themegallery.comCompanyLogo操作步骤PROCEDURALSTEPS1．仰卧，头垫高10cm，置入导管芯,将病人头部尽量

8、向后伸仰，使三轴线完全重叠，让插管径路接近为一直线。Positionbedhei