hfbHealth, Food & BiotechnologyHealth, Food & Biotechnology2712-7648РОСБИОТЕХ10.36107/hfb.2019.i2.s165hfb-4Research ArticleЗДОРОВЬЕHEALTHДеканюляция. Три шага к успехуDecanulation. Three Steps to SuccessИнкинаА. В.InkinaA. V.

Инкина Анна Васильевна

129110, Москва, ул. Щепкина, дом 61/2

Anna V. Inkina

61/2, Shepkina street, Moscow, 129110

larynx07@rambler.ruНаседкинА. Н.NasedkinA. N.

Наседкин Алексей Николаевич

125080, Москва, Волоколамское шоссе, дом 11

Aleksey N. Nasedkin

11 Volokolamskoe highway, Moscow, 125080

nasedkinan@mgupp.ruГрачевН. С.GarchevN. S.

Грачев Николай Сергеевич

125080, Москва, Волоколамское шоссе, дом 11

Nikolay S. Garchev

11 Volokolamskoe highway, Moscow, 125080

nick-grachev@yandex.ruГБУЗ МО МОНИКИ им. М.Ф. ВладимирскогоРоссияSBHI of MA MRRCI n.a. M.F. VladimirskiyRussian FederationФГБОУ ВО «Московский государственный университет пищевых производств»РоссияMoscow State University of Food ProductionRussian Federation201903052021121116Copyright © Инкина А.В., Наседкин А.Н., Грачев Н.С., 20212021Инкина А.В., Наседкин А.Н., Грачев Н.С.Inkina A.V., Nasedkin A.N., Garchev N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.hfb-journal.ru/jour/article/view/4

Статья посвящена деканюляции, которая необходима после проведения трахеостомии. Деканюляция является заключительной процедурой хирургического вмешательства. Это процесс окончательного удаления трахеостомической трубки, после которой наступает выздоровление и восстановление пациента. Несмотря на всю важность деканюляции, до сих пор не существует единого универсального стандарта и протокола проведения этой процедуры, доступная литература состоит из экспертных заключений и опросов. В зарубежной и отечественной литературе широко освещается вопрос деканюляции пациентов, но единого алгоритма на данный момент не существует. Многолетний опыт работы с канюленосителями в ЛОР клинике Московского областного научно- исследовательского клинического институт им. М.Ф. Владимирского, с 2000 по 2017 года позволил нам разработать протокол подготовки взрослых пациентов, находящихся в сознании и на самостоятельном дыхании, к проведению деканюляции, состоящий из 3 пунктов для оценки состояния пациента: 1) оценка эффективности кашлевого рефлекса; 2) оценка эффективности глотания; 3) оценка эффективности состояния дыхательной функции. Процедура денакюляции была успешно проведена у 256 пациентов в возрасте от 18-78 лет, из них 144 мужчины и 112 женщины. Нами предложен простой в практическом применении протокол подготовки взрослых пациентов, находящихся в сознании и на самостоятельном дыхании, к проведению деканюляции. После проведения процедуры деканюляции пациент должен находиться под наблюдением медперсонала первые несколько суток. После закрытия стомы рекомендуется проводить наблюдение в течение 3 месяцев.

The article is devoted to decannulation, which is necessary after the tracheostomy. Decannulation is a final surgical procedure. This is the process of the final removal of the tracheostomy tube, after which the patient comes to recovery and restoration to health and strength. Despite the importance of decannulation, there is still no single universal standard and protocol for conducting this procedure, the available literature consists of expert opinions and surveys. Years of experience in hospital (Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky) from 2000 to 2017 allowed us to develop a protocol for the patients, who were conscious and self-breathing, to conduct decannulation. The protocol consists of 3 steps for assessing the patient's condition: 1) assessment the effectiveness of the cough reflex; 2) evaluation of the effectiveness of swallowing; 3) assessment of the effectiveness of the state of the respiratory function. The procedure of decannulation was successfully performed in 256 patients aged 18-78 (144 men and 112 women. An easy-to-use protocol for the preparation of adult patients who are conscious and independent of breathing is proposed for decanulation. After the procedure of decanulation, the patient should be under the supervision of medical staff for the first few days. After stoma closure, it is recommended to monitor patients for 3 months.

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The authors declare that there are no conflicts of interest present.