三腔两囊管 (1)课件

Theclinicalapplication

ofSengstaken-blackmoreTube

Acute

gastrointestinal

bleeding

isacommonlyencounteredchiefcomplaintwithahighmorbidityandmortality.with

gastrointestinal

bleeding,identifythesourceof

bleeding,stopcontinued

bleeding,supportoxygencarryingcapacity,andpreventrebleedingisveryimportant。Themosteffectivemethodisthe

hemostasisbycompressionoftree-way

and

two-capsula。Therefore,Whetherthesurgerycansucceedisdepandonthetree-way

and

two-capsula。Introduction目录ContentsTheprinciple1Indicationsandcontraindications2Method3TheprincipleIndicationsandcontraindicationsIndications1、transfusion,fluidinfusionand

hemostatic

drugscan’tstopbleeding.2、therebleedingwhichiscaused

byPostoperation,

EndoscopicsclerotherapyandafterEndoscopicVaricealLigationandthecommonhemostatic

wayshavenoeffect.3、patientwhois

short

ofemergency

surgical

conditions

Indications

:applytothepatients

ofportal

hypertension

associatedwithgastric

variceal

bleeding

whichthecommonhemostatic

waysisdiffculttostop.1patientsinseriousandindeedcoma2throatneoplasms,

esophagealtumorandhavehadsurgery3thoracoabdominalaneurysm

4coronary

heart

disease,HypertensionandheartdysfunctionContraindicationsMethodPreparingmaterials

PreoperativePreparation

Put

tube

Post-operativecareMethod1.Checkballoon:implanted

gasestogastricballoonandesophagusballoon

（150-200mland100-150ml）make

suretheballoonisintact.2.Patientposition:semireclining

positionorhorizontal

position

turning

the

head

to

oneside.3.measuringtubeand

moistentube：fromhair

linetoProcessus

xiphoideus+8～10

cm，markand

Smearparoline.PreoperativePreparationMethod132

loosetraction

Observethe

hemostaticeffectExtubatePost-operativecareLoosethetractionifthereisnobleedingafter

intubationover12h.Ifnot,extendto24h.Releaseair10-20minevery12h,ifitcontinuous

bleedingafterreleaseairweneedtractionagain,Itwas

suggestedfailure

tohemostasisifbleedingover72h.Releaseairandobserveifthereisnobleedingafter2~3days,take20~30mlparoline

incaseof

nobleedingover24hand

extubateafter10mins.1gastric

ulcer，esophagealulcer,

mucosaulceravascular

necrosis2Dyspnea,asphyxia3aspiration

pneumonia

4arrhythmia：moreprematureheartbeat

Complication5Oesophagusperforation

MethodMethod1.Infuse

air：Fromgastricballoontoesophagealballoon.

Releaseair：Fromesophagealballoontogastricballoon.2.

Depthoftubeinsert.3.

WeightofTraction.4.Payattention

topatient’sVitalsignsand

conscio