| Objective:To modify a safe,convenient and comfortable tracheotomy tube ties,and evaluate its clinical application.Methods:Investigation and analysis the common types and the clinical application about tracheotomy tube ties,designing and producing a novel tracheotomy tube tie,which is parallel double belt and detachable connector.Through the design of parallel double belt,increased the contacting area between the tracheotomy tube tie and the patients neck skin,improved the wearing comfort.Through the design of detachable connector,we can exchange the dressing and cleaning the tracheotomy tube tie without loosening the whole ties.To avoid the risk of the decannulation caused by the cleaning the ties or the operation of dressing change.Enrolled 150 tracheotomy patients from Otolaryngology Head and neck surgery,Neurosurgery,Neurology and ICU in First hospital of Shanxi Medical University in June 2016 to March 2017,were randomly divided into three groups,each group was 50 cases,choosing two kinds of clinical commonly used tracheotomy tube ties,traditional cotton tracheotomy tube ties(the control group A),Xin Ruide ? tracheotomy tube ties(the control group B),compared with the modified tracheotomy tube ties(experimental group).Observing and recording the tracheotomy patients in postoperative 3days,7 days,14 days on skin damage,patient comfort,difficulty level,time,frequency of exchanging tracheotomy tube ties and dressing,rate of tube decannulation.Results:1.Product a modified parallel double belt and detachable connector tracheotomy tube tie,and obtain a patent(Patent No.201620440991X).2.The clinical trial enrolled 150 patients,no lost and early exit.There is no statistical significance on comparison of difference in age,sex,clinical diagnosis,APACHE score,Branden score(P>0.05).The groups were comparable.3.Compared with the damage of neck skin,the control group A was 22%,the control group B was 14%,the experimental group was 4%,there was statistically differences between the three groups(P<0.05),comparison between groups,the skin damage about control group A was higher than that of the control group B,the control group B was higher than that of the experimental group,there were statistically differences(P<0.05);Compared with the patients comfort VAS score about neck skin,day 3after tracheotomy,the VAS score of the control group A was(8.56±0.58),the control group B was(7.36±0.69),the experimental group was(3.98±0.84),day 7after tracheotomy,the VAS score of the control group A was(7.48±0.65),the control group B was(6.4±0.76),the experimental group was(3.1±0.76),day 14 after tracheotomy,the VAS score of the control group A was(6.58±0.64),the control group B was(5.74±0.75),the experimental group was(2.4±0.64),three groups of patients wearing comfort was statistically differences(P<0.05),compared with the groups,the comfort degree of the experimental group was higher than that of the control group A,B in all time points,control group B was higher than that of the control group A,there were statistically differences(P<0.05);Compared with the VAS score degree of difficulty on nurses replaced the tracheotomy tube ties,the control group A was(7.06±1.11),the control group B was(6.22±1.02),the experimental group was(3.32±0.87),there were statistically difference between three groups(P<0.05),compared with the groups,the experimental group was more easier than the control group A and B,the control group B was easier than the control group A,there were statistically difference(P<0.05);Compared with the VAS score degree of difficulty on nurses replaced the dressing change,the experimental group was(3.22±0.86),the control group A was(6.60±0.73),the control group B was(6.46±0.84),the experimental group was statistically difference with the control group A,B(P<0.05),the control group A and B was no statistically difference(P>0.05);Compared with the accidental decannulation of tracheotomy tube,there were no statistically difference between the three groups(P>0.05).Conclusion:1.The modified parallel double belt and detachable connector tracheotomy tube ties matched with the operating requirements,safe,convenient and effective.2.Compared with clinical application effect in three groups,showed The modified tracheotomy tube ties can significantly reduce skin damage,increased the patients comfort,tracheotomy tube ties is more easily replaced,and in a short time,and can be contaminated,cleaning,disinfection,reduced the number of replacement,reduced the workload of nurses,reduced the pain of patients,dressing is more easily replaced,and in a short time;reduced the risk of tube decannulation,more suitable for the patients with tracheotomy,worthy of clinical spread and application. |
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