动脉测压管引导经口气管导管改经鼻气管导管置换术  

Arterial Pressure Measured Ducts Aiming Tracheal Tube via mouth Replacement with Tracheal Tube via nose

作　　者：潘景业[1] 全世超[1] 

机构地区：[1]温州医学院附属第一医院,325000

出　　处：《医学研究通讯》2005年第6期52-54,共3页Bulletin of Medical Research

摘　　要：目的观察应用动脉测压管做引导,置换经口气管导管为经鼻气管导管的临床效果;方法通过30例经口气管内插管的病人由于需要长期气管插管,而要改为经鼻插管,对照组(n=22)使用先拔经口气管内插管再用纤支镜引导经鼻插管的老办法,而试验组(n=8)通过徒手(不借助其他如纤支镜等器械)将引导管沿鼻腔插至咽部,由咽部拉到口腔外,再插入原经口气管导管内至隆突水平,并剪开拔出原经口气管导管;将经鼻气管导管套在引导管外,在引导管引导下将气管导管插入气管内,完成换置;结果全部30例病例均顺利完成更换气管导管,但相比较试验组在换管过程中病人氧合良好,心率血压变化小,鼻出血发生率低,总耗时短,术后未发生与更换导管相关并发症。结论应用气管导管置换,方法安全、简便易行,可替代传统的先拔管再借助纤支镜引导插管换管的方法。Objective To observe and apply clinical effects of arterial pressure measured ducts aiming and replacing tracheal tubes via mouth with tracheal tube via nose.Methods 30 patients with trachea cannulas via mouth should be replacing with trachea cannulas via nose as a result of need endotracheal intubation for a long time.22 patients in the control group were operated in the conventional way of extubation before trachea cannula via mouse aimed by the FOB(fiberoptie bronchoscope),replacement over.8 patients in the empirical group were barehanded(by no means of any apparatuses like the FOB)to insert aiming ducts into nose and pull it out through mouth,then insert it into the tracheal tubes via mouth,then extubation by cut the tracheal tubes via mouth;Aiming ducts were sheathed with well-to-be replaced tracheal tubes and new tra- cheal tubes were inserted into trachea aimed by aiming tubes,replacement over.Results 30 total patients in the empirical group and the control group were replaced successfully by trachea cannula via nose,after which severe complication did not occur.Compared with the control group, patients in the empirical group showed that oxygenation were more stable,heart rate blood pressure changed little,and hemorrhinia happened with low rate,or with short periods.Conclusion It was safe and easy to apply tracheal tube replacement and such replacement can be applied to clinics instead of conventional way of extubating before replacing trachea cannula via nose aimed by the FOB.

关 键 词：经口气管导管 鼻气管导管 动脉测压管 经口气管内插管 置换术 导管相关并发症 气管导管插入 经鼻插管 纤支镜引导 临床效果 气管插管 经鼻气管 导管引导 比较试验 血压变化 引导插管 引导管 对照组 导管内 发生率 鼻出血 

分 类 号：R615[医药卫生—外科学] R765.9[医药卫生—临床医学]