Abstract:

Objective To design a special protective shield for tracheostoma after total laryngostomy with the function of volume-controlled humidification，heating and filtration，and to evaluate its application effect in patients with laryngostomy after laryngeal cancer surgery. Methods The protective shield consists of 4 parts：a laryngostomy protection module fitting the neck curve，ventilation filter module，ear-hook continuous humidification module and humidification liquid constant temperature system. A total of 110 laryngeal cancer patients who underwent total laryngectomy in the otolaryngology department of a tertiary A hospital in Hangzhou from January 2020 to December 2021 were selected as the research subjects. The patients were divided into an experimental group and a control group by random number table，with 55 cases in each group. The experimental group was given airway care with the self-designed special protective shields for laryngostomy，while the control group was given routine airway care. The volume，color，and crusting degree of sputum，airway comfort，daily airway humidification，sleep quality，and whether return to society were compared between the 2 groups a month after discharge. Results The amount of phlegm in the airway of the experimental group was less than that of the control group；the degree of phlegm scab was less than that of the control group；the situation of social reintegration was better than that of the control group；the difference between the 2 groups was statistically significant（P<0.05）. Conclusion The new type of laryngeal shields can effectively protect the patient’s airway in manual airway care，avoid foreign body invasion，reduce water loss of airway and sputum volume，prevent from sputum crusting，and it plays a role in continuing nursing after the patient is discharged conveniently and efficiently.

Key words: Laryngeal Carcinoma, Laryngectomy, Tracheostomy, Protective Shields, Nursing Care

摘要：

目的 设计具有量控、湿化、加温及过滤作用的全喉切除术后气管造口专用保护罩，并评价其在喉癌术后气管造口患者中的应用效果。方法 气管造口专用保护罩由贴合颈部曲线的气管造口防护模块、通气过滤模块、耳挂式湿化液滴注模块、湿化液加温恒温系统4个模块组成。便利选取2020年1月—2021年12月于杭州市某三级甲等综合医院耳鼻咽喉科行全喉切除术后建立人工气道的110例喉癌患者为研究对象，采用随机数字法分为试验组和对照组，每组各55例。试验组采用自行设计的气管造口专用保护罩进行气道护理，对照组采用常规气道护理。比较两组出院1个月后气道痰量、痰液颜色、痰液结痂程度、气道舒适度、每日气道湿化量、睡眠质量及重返社会情况等指标。结果 两组各51例完成研究。试验组气道痰量少于对照组，痰液结痂程度低于对照组，重返社会情况优于对照组，差异均具有统计学意义（P<0.05）。结论 该研究设计的气管造口专用保护罩能有效保护患者的气管造口，避免异物侵袭，减少气道失水量，预防痰液结痂，促使痰量下降，可作为全喉切除术后气管造口患者的气道管理工具。

关键词: 喉肿瘤, 喉切除术, 气管造口术, 保护罩, 护理