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Care
术后护理
After tracheostomy is done, certain precautions and care is required to ensure proper functioning of the tracheostomy tube and to prevent complications.
气管切开术后，需要一定的预防和护理，以确保气管切开管的正常功能，并防止并发症。
The tracheostomy forces the air to bypass the nasal and oral passages, hence the air entering the tracheostomy is not adequately humidified.
气管切开术迫使空气绕过鼻腔和口腔通道，因此进入气管切开术的空气没有充分湿化。
This dry air leads to increased tracheal irritation and secretion production.
这种干燥的空气会增加气管刺激和分泌物的产生。
Because these secretions may lead to crusting and blockage of the tracheostomy tube, the first point regarding care is adequate suctioning of the secretions through the tracheostomy tube.
因为这些分泌物可能会导致气管造口管结痂和堵塞，所以护理的第一要点就是通过气管造口管充分地吸出分泌物。
Secondly, humidification of air.
第二，空气的加湿。
This can be done with humidified air attached to the tube, placing a humidifier or steam near the patient’s bed or applying a wet porous gauze onto the tracheostomy tube, although the latter is considered a crude measure.
这可以通过将加湿的空气附在管子上，在患者床边放置加湿器或蒸汽，或者在气管造口管上用湿润的多孔纱布来实现，尽管后者被认为是一种粗糙的方法。
Thirdly, keep the patient under regular supervision and ensure that the tube is functioning and not dislodged.
第三，定期监护病人，确保导管功能正常，不脱位。
Since the tracheostomy forces the air to bypass the vocal cords, patients would not be able to speak effectively.
由于气管切开术迫使空气绕过声带，患者将无法有效说话。
In such cases, a note pad and bell should be provided to the patient, to allow them to communicate effectively with their healthcare providers.
在这种情况下，应为患者提供记事本和铃铛，使他们能够与医疗保健提供者进行有效的沟通。
Fourthly, if the patient has a cuffed tracheostomy in place, then the cuff should be deflated periodically to relieve pressure on the trachea.
第四，如果病人做了带套囊的气管造口术，那么套囊应该定期放气，以减轻气管的压力。
However, this may not be feasible in patients with increased risk of aspiration.
然而，这在吸入性风险增加的患者中可能不可行。
In case the tracheostomy tube is damaged, infected, occluded or non functioning in any way, then a new tube should be inserted in place of the old one, under expert supervision.
如果气管切开术插管损坏、感染、阻塞或以任何方式不起作用，则应在专家的监督下插入新管代替旧管。
Complications
并发症
Just like any invasive procedure, tracheostomy also has some potential complications.
就像任何侵入性手术一样，气管切开术也有一些潜在的并发症。
Surrounding structures may be damaged while performing the procedure.
在执行该程序时，可能会损坏周围的结构。
Therefore, there could be bleeding around the tracheostomy site.
因此，气管切开部位周围可能有出血。
Tracheostomy tube may get blocked by secretions or clots, or it may get dislodged.
气管切开管可能会被分泌物或凝块堵塞，也可能会移位。
The dry air directly entering the trachea might cause tracheitis and crusting.
干燥的空气直接进入气管可能会引起气管炎和结痂。
The patient may have initial difficulty getting used to breathing via tracheostomy, along with apnea.
患者最初可能难以适应通过气管切开来呼吸，并伴有呼吸暂停。
There may be infections of the surgical wound, trachea or lungs.
手术伤口、气管或肺部可能有感染。
Decannulation
拔管
If the patient improves and the healthcare team determines that tracheostomy is no longer necessary, then a trial of decannulation should be attempted.
如果患者病情好转，且医疗团队确定不再需要气管切开，则应尝试拔管。
Decannulation is basically the removal of the tracheostomy tube and shifting the patient back to normal breathing.
拔管基本上是拔除气管造口管，使病人恢复正常呼吸。
The tube is occluded for 24 hours and if the patient is able to tolerate it and breathe normally then the tube is removed and the wound closed.
拔管前堵塞24小时，如果患者能够耐受并正常呼吸，即可拔管，伤口会自行愈合。
If patient is unable to tolerate the tube occlusion, then progressively, smaller tracheostomy tube are inserted and occluded, until patient is able to resume normal breathing.
如果患者无法忍受气管闭塞，可插入较小的气管造口管，逐渐闭塞，直到患者能够恢复正常呼吸。
