魏氏喷射气管导管用于患者气管插管术的效果  

Efficacy of ＂jet endotracheal tube＂ designed by Wei for tracheal intubation

作　　者：彭俊[1] 叶健鸿[2] 赵一凡[1] 梁建军[1] 黄海量[1] 彭书崚[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州市510120 [2]中山大学附属第一医院麻醉科

出　　处：《中华麻醉学杂志》2013年第1期72-75,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价魏氏喷射气管导管用于患者气管插管术的效果。方法择期全麻气管插管术患者102例，性别不限，年龄15～50岁，体重40～99kg，ASA分级Ⅰ～Ⅲ级，Cormack＆Lehane分级Ⅰ～Ⅳ级（Ⅰ或Ⅱ级为非困难气道，Ⅲ或Ⅳ级为困难气道）。采用随机数字表法，将患者随机分为2组（n：51）：常规导管组（C组）和魏氏喷射气管导管组（WJ组）。2组根据Cormack＆Lehane分级分为2个亚组：困难气道组（n=16）和非困难气道亚组（n=35）。C组使用普通Kendall气管导管进行插管；WJ组使用相同内径的魏氏喷射气管导管，在喷射通气同时行气管插管。记录机械通气即刻PETCO2；记录首次气管插管成功情况及气管插管时问；记录气管导管拔除后24h内的并发症发生情况。结果与C组比较，WJ组气管插管时间延长，困难气道患者气管插管首次成功率升高（P〈0．01）。与非困难气道患者比较，WJ组困难气道患者机械通气即刻PETCO2、气管插管时间和首次成功率比较差异无统计学意义（P〉0．05），C组困难气道患者机械通气即刻PETCO，升高，气管插管首次成功率降低（P〈0．01）。WJ组未出现气胸、纵隔气肿及皮下气肿等严重气压伤；2组喉痉挛、咽喉痛和胃胀气发生率比较差异无统计学意义（P〉0．05）。结论魏氏喷射气管导管不仅能安全有效地为气管插管全麻患者提供通气，还可提高困难气道气管插管成功几率。Objective To investigate the efficacy of ＂jet endotracheal tube＂ （JET） designed by Wei （ WEI JET） for tracheal intubation. Methods One hundred and two ASA I -III and Cormack ＆ i^ehane grade I - IV patients of both sexes, aged 15-50 yr, weighing 40-99 kg, requiring tracheal intubation under general anesthesia, were randomly allocated into 2 groups （n = 51 each） ： conventional tracheal tube group （group C） and WEI JET group （group WJ）. Groups C and WJ were further divided into 2 subgroups according to Eormack ＆ Lehane grade： difficult airway subgroup （n = 16） and non-difficult airway subgroup （n = 35）. The patients were tracheal intubated with the common Kendall endotracheal tube in group C. Jet ventilation （driving pressure 100 kPa, frequency of ventilation 15 bpm, I：E = 1 ：2） was performed and the patients were simultaneously tracheal intubated with WEI JET of the same internal diameter in group WJ. PETCO2 was recorded immediately after mechanical ventilation. The success rate of tracheal intubation at first attempt and time spent were recorded. The complications were also recorded within 24 h after extubation. Results Compared with group C, the intubation time was significantly prolonged, and the success rate of tracheal intubation at first attempt was increased in patients with a difficult airway than that in the patients without difficult airways in group WJ （ P 〈 0.01 ）. There was no significant difference in PET COL recorded immediately after mechanical ventilation, intubation time and the success rate of tracheal intu- bation at first attempt between the patients with a difficult airway and the ones without difficult airways in group WJ （P 〉 0.05）. PET CO2 recorded immediately after mechanical ventilation was significantly higher and the success rate of tracheal intubation at first attempt was lower in the patients with a difficult airway than in the patients without difficult airways in group C （ P 〈 0.01 ）. No severe barotrauma such as pneu

关 键 词：插管法 气管内 呼吸 人工 

分 类 号：R614[医药卫生—麻醉学]