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医学科普Tracheotomy气管切开术
Whatisatracheotomy?
Atracheotomyisasurgicalprocedurethatcreatesanopeninginyourneckandwindpipe(trachea气管).Atubeisthenplacedintheopeningtokeepitopen.Theproceduremakesanotherwayforairtogettoyourlungs.
Thetermstracheotomy,tracheostomy气管造口术,andtrach气管切开maybeusedtorefertoboththesurgicalprocedureandtotheopeningcreatedbytheprocedure.
Whenisitused?
Atracheotomymaybedonewhenyouhaveaproblemwithyourairwayandyouarenotgettingenoughairtoyourlungs.Iftheupperairwayisblocked,atracheotomycanbypass绕过theblockage阻塞物toprovideairflow气流toyourlungs.Itisalsousedtoprovideoxygentothelungsmoreefficientlyandtoclearsecretionsfromtheairway.
Examplesofwhenyoumightneedatracheotomyare:
Yourupperairwayisblockedbyswelling,aninjury,atumor肿瘤,aforeignbody异物,vocalcord声带problems,oraseverenarrowingofthetrachea.
Youwillbeonabreathingmachine(ventilator呼吸机)foralongtime.
Youhavelotsofsecretionsthatyoucannotgetridofandsoyouneedfrequentsuctioning吸痰ofyourairway.Forexample,youmaynotbeabletoswallowsaliva唾液becauseyourthroatmusclesareparalyzedandsomeofthesalivamaygetintoyourlungs.
Whathappensduringtheprocedure?
Atracheotomyisusuallydoneinanoperatingroomorinanintensivecareunit.Yourheartrateandoxygenlevelsaremonitored监测duringtheprocedure.
Firstyouaregivenananesthetic.Theanestheticshouldkeepyoufromfeelingpainduringtheprocedure.Thenthesurgeonmakesacut(incision)inyourneckandtracheaintheareaoftheneckbelowthelarynx喉(Adamsapple喉结orvoicebox喉头).Atubeisplacedintheopening.(Theopeningiscalledastoma气切口,ortracheostomy气管造口术.)Thetubeisheldinplacewithabandorlacesaroundtheneck.
Whathappensaftertheprocedure?
Thetracheotomysitewillbegintohealandyoursurgeonwillmonitoryouforafewdays.Theoriginaltubeisusuallykeptinplacefor5to10days.Afterthatanewtubemaybeused.
Ifyouareonaventilator,thetubewillhaveaballoonarounditthatpreventsairfromleaking漏气.Inthiscaseyouwillnotbeabletotalk.Ifyoudonotneedaventilator,asmallertubemaybeusedthatallowsairtopassaroundit.Inthiscaseyoumaybeabletotalk.
Atracheostomymaybetemporary临时orpermanent永久.Ifyounolongerneedit,yoursurgeonwillremovethetubeandallowtheopeningtocloseonitsown.Ifitdoesnotclosein4to6months,itmaybeclosedwithsurgery.
Whatarethebenefits?
Youwillbeabletogetoxygentoyourlungs.Theproceduremaysaveyourlife.
Whataretherisks?
Problemsthatatracheotomymaycauseare:
bleeding
infection
damagetothevoicebox(larynx)
troubleswallowing吞咽困难
scarring结疤.
HowdoIcareforatracheotomy?
Ifyoustillhavethetracheotomywhenyougohomefromthehospital,youoryourfamilywillbetaughthowtocareforthetracheotomy.Thiswillincludecleaningthetrachsite,suctioning,andchangingthetube.
Youmayhaveaninnercannula(tube)内套管thatfitsintotheoutertubeofthetracheotomy.Thisinnertubehelpskeepsecretionssuchasmucusoutofthetracheotomysoyourbreathingisntblocked.Youneedtocleanthistubeatleastonceaday.Thebasicstepsforcleaningthetubeare:
Washyourhandswithsoapandwarmwater.
Removetheinnercannulafromthetrachtube.
Usehydrogenperoxide过氧化氢andatrachbrushorsoftpipecleanertocleantheinnercannulaandremovesecretions.Youmayneedtosoakthecannulafirstinhydrogenperoxideforafewminutesifitisverydirty.
Rinsetheinnercannulathoroughlywithdistilledwaterorasalinesolution蒸馏水或盐水.
Shakeexcesswaterfromthecannula.
Putthecleaninnercannulabackinplaceassoonasyouaredonecleaningit.Lockitinplace.
WhenshouldIcallmyhealthcareprovider?
Calloryourproviderrightawayif:
Youcannotreplacethetrachtube.
Youcannotbreatheeasilyaftersuctioningandchangingthetrachtubeorinnercannula.
Youhavebleedingthatdoesnotstop.
Callduringofficehoursif:
Secretionshavechangedincolor,consistency粘稠度,orodor气味.
Itisharderforyoutoswallow.
Youhavenon-life-threateningchangesinyourbreathingpattern.
Youhavesoundsfromthetrachtubeorcoughingthatdonotgoawayaftersuctioning.
Disclaimer:Thiscontentisreviewedperiodicallyandissubjecttochangeasnewhealthinformationbe
