METHOD OF TREATING TROPHIC INJURIES OF LARYNX AND TRACHEA IN PATIENTS WITH TRACHEOSTOMA ON LONG-TERM ARTIFICIAL LUNG VENTILATION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to field of resuscitation and can be used in case of intubation injuries of larynx and trachea in patients with tracheostoma on long-term artificial lung ventilation (ALV). For this purpose bronchoscope is introduced through preliminarily installed tracheostomic tube and through free glottis in antegrade way. After that, aspiration and sanitation are performed step-by-step. First, content of distal part of trachea and bronchi is aspirated through tube opening. Then, bronchoscope is introduced through free glottis, and content from pharynx, pyriform sinuses, larynx and proximal part of trachea, distally limited with tube cuff, is aspirated with cuff being blown up. After that, aspiration is carried out from trachea lumen at the level of cuff and under-cuff part of tube, with cuff being blown down. At each step of performed procedures character of changes in mucous membrane of each organ is estimated visually, and if erosive-ulcerous injuries of larynx and trachea are detected, laser light guide is introduced through bronchoscope canal with further irradiation with laser radiation. Wavelength is 700 nm, frequency is 2500 Hz. Sessions of irradiation are carried out until erosions and ulcers are completely healed. In case if cartilage fragments or granulations are present, their electric excision with current intensity not higher than 10 mA is performed.;EFFECT: method makes it possible to ensure efficient treatment of intubation-induced pharynx and trachea injuries in said category of patients due to timely step-by-step adequate sanitation and treatment of trachea and bronchi.;3 ex