Li Wenxiu, Chen Xiaojie, Zhang Yingjie, Ding Fang
Department of Intensive Care Medicine, Harrison International Peace Hospital Affiliated to Hebei Medical University (Hengshui People's Hospital), Hengshui 053000, Hebei, China.
Department of Nursing, Harrison International Peace Hospital (Hengshui People's Hospital), Hebei Medical University, Hengshui 053000, Hebei, China. Corresponding author: Chen Xiaojie, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 Mar;34(3):311-314. doi: 10.3760/cma.j.cn121430-20211011-01458.
With the development of medical technology, the fixation method of the oral duct is constantly updated, and the selection of a relatively safe, effective, simple and fast fixation method of the oral duct has been widely concerned. However, the use of traditional 3M I-shaped tape fixation needs to be cut, which wastes time and easily leads to the outward displacement of the tracheal tube, and is easy to be soaked by oral secretions, resulting in facial skin damage. Therefore, the medical staffs of the department of critical care medicine of Hengshui People's Hospital designed a self-made tracheal catheter fixing band (composed of the main structure, the fixed band, the internal adjusting structure and the internal structure of the fixed block), and obtained the national utility model patent (ZL 2018 2 0508681.6). The inner side of the fixing band is fixed with a spongy body, which can absorb the secretions around the mouth to avoid the moist condition around the mouth and cheek skin. Meanwhile, the endotracheal catheter is fixed with the help of the card slot, hinge and other structures, which can fully ensure the fixation effect. A total of 80 patients undergoing airway intubation were admitted to the department of critical care medicine of our hospital from October 2020 to September 2021. They were divided into observation group and control group according to intubation time (single number and double number), with 40 patients in each group. The observation group was fixed with self-made tracheal catheter fixation band. Through evidence-based practice path, relevant literatures at home and abroad were searched for clinical practice basis, and the practice plan was formulated and implemented. The control group was fixed with 3M tape + inch tape according to the traditional method. The fixation of tracheal tube and the degree of facial skin injury were compared between the two groups. All patients were included in the final analysis without shedding cases. Severe catheter displacement occurred in 3 patients (7.5%) in the control group, and no severe catheter displacement occurred in the observation group. The incidence of facial skin injury in the observation group was significantly lower than that in the control group [25.0% (10/40) vs. 55.0% (22/40), P < 0.05]. Moreover, the fixation time of the observation group was significantly shorter than that of the control group (minute: 12.11±1.69 vs 17.59±1.27, P < 0.05). The application of self-made tracheal catheter fixation band can shorten the fixation time of tracheal catheter and reduce the incidence of unplanned endotracheal extubation (UEE) and facial skin injury, which is worthy of clinical promotion and application.
随着医学技术的发展，口咽通气道的固定方法不断更新，选择一种相对安全、有效、简便、快速的口咽通气道固定方法受到广泛关注。然而，传统3M工字胶布固定需裁剪，浪费时间且易导致气管导管向外移位，还易被口腔分泌物浸湿，造成面部皮肤损伤。因此，衡水市人民医院重症医学科医护人员设计了一种自制气管导管固定带（由主体结构、固定带、内部调节结构及固定块内部结构组成），并获得国家实用新型专利（ZL 2018 2 0508681.6）。固定带内侧固定有海绵体，可吸收口腔周围分泌物，避免口周及面颊皮肤潮湿。同时，借助卡槽、铰链等结构固定气管导管，能充分保证固定效果。20年10月至21年9月，我院重症医学科共收治80例接受气道插管的患者。根据插管时间（单号和双号）分为观察组和对照组，每组40例。观察组采用自制气管导管固定带固定。通过循证实践路径，检索国内外相关文献作为临床实践依据，制定并实施实践方案。对照组按传统方法采用3M胶布+寸带固定。比较两组气管导管固定情况及面部皮肤损伤程度。所有患者均纳入最终分析，无脱落病例。对照组发生严重导管移位3例（7.5%），观察组未发生严重导管移位。观察组面部皮肤损伤发生率显著低于对照组[25.0%（10/40）比55.0%（22/40），P<0.05]。此外，观察组固定时间显著短于对照组（分钟：12.11±1.69比17.59±1.27，P<0.05）。自制气管导管固定带的应用可缩短气管导管固定时间，降低非计划气管拔管（UEE）发生率及面部皮肤损伤发生率，值得临床推广应用。
