食管气管引导管在舌颌颈术后气道管理中的应用  

Application of oesophageal-tracheal tube in postoperative airway management of tongue-chin-neck surgery

作　　者：朱也森[1] 姜虹[1] 徐辉[1] 刘和平[1] 

机构地区：[1]上海第二医科大学第九人民医院麻醉科,上海200011

出　　处：《上海第二医科大学学报》2004年第11期923-925,929,共4页Acta Universitatis Medicinalis Secondae Shanghai

基　　金：上海市卫生局基金 (0 0 4 2 5)资助项目

摘　　要：目的探讨食管气管引导管在舌颌颈术后气道管理中的应用。方法 38例原拟定舌颌颈术后做预防性气管切开的病例 ,分为三组 ,组Ⅰ (11例 )不做气管切开 ,术后留置气管导管 ;组Ⅱ (12例 )不做气管切开 ,术后 2 4h拨除气管导管 ,给予食管气管引导管作通气支持 ;组Ⅲ (15例 )手术结束时即施行预防性气管切开。结果放置引导管通气后 ,组Ⅱ的BIS、MAP和HR较放置前、未拔除气管导管时有明显下降 (P <0 .0 5 ) ;组Ⅱ的BIS明显低于组Ⅰ、Ⅲ ,组Ⅰ的MAP、HR明显高于其它两组 (P <0 .0 5 )。三组中 ,组Ⅰ、Ⅱ的拔管时间明显短于组Ⅲ ,组Ⅰ、Ⅲ呛咳、咳痰发生率高于组Ⅱ ,组Ⅰ的咽喉疼痛发生率较高 (P <0 .0 5 )。结论食管气管引导管用于舌颌颈术后气道管理 ,通气效果确切 ,刺激小 ,并发症少 ,可有效避免做预防性气管切开 。Objective To study the application of oesophageal-tracheal tube(OT) in postoperative airway management of tongue-chin-neck surgery. Methods Thirty-eight patients who needed to be done preventive tracheotomy were devided into three groups.GroupⅠ with 11 cases who were not done tracheotomy were not extubated after surgery. Group Ⅱ with 12 cases who were not done tracheotomy were extubated and ventilated by inserting an oesophageal-tracheal tube after surgery 24 h. Group Ⅲ with 15 cases were done preventive tracheotomy at the end of operation. Results In group Ⅱ, BIS,MAP,HR decreased obviously(P<0.05)after ventilated by OT than before extubated tracheal tube. BIS was siginificantly lower(P<0.05)in group Ⅱ than in groupⅠ or groupⅢ. MAP,HR were obviously higher(P<0.05) in groupⅠ than in the other groups. The time to extubation was obvious less in groupⅠor groupⅡ than in groupⅢ(P<0.05).The rate of cough was higher(P<0.05) in groupⅠor groupⅢ than in groupⅡ. The rate of throat pain was higher(P<0.05)in groupⅠ. Conclusion It is well ventilated by oesophageal-tracheal tube in postoperative airway management of tongue-chin-neck surgery,with small stress and few complications. It can avoid being done preventive tracheotomy within its applicability.

关 键 词：食管气管引导管 预防性气管切开 气道管理 气道困难 口腔颌面外科 围术期管理 

分 类 号：R614[医药卫生—麻醉学]