预防误吸型胃管的临床应用  

Clinical application of aspiration-prevented gastric tube

作　　者：杨小林[1] 孙玉峰[1] 吴宏伟[1] 李淑云[2] 陈小萍[2] 范海燕[2] 陈丽霞[2] 陈海涛[3] 

机构地区：[1]如皋市人民医院麻醉科,江苏省226500 [2]如皋市人民医院护理部,江苏省226500 [3]南通市肿瘤医院

出　　处：《江苏医药》2013年第11期1312-1313,共2页Jiangsu Medical Journal

基　　金：2009年南通市市级社会发展科技计划项目(S9939);2009年度如皋市科技局资助项目(rg2009066)

摘　　要：目的评价预防误吸型胃管的临床效果及安全性。方法饱胃(餐后2-h)且需在全麻下行急诊手术患者45例随机均分为三组:A组套囊充气10ml;B组套囊充气15ml;C组套囊充气20ml。每组再分均为三个亚组,在相应充气容量下持续充气30min(A1组、B1组、C1组)、60min(A2组、B2组、C2组)、120min(A3组、B3组、C3组)时记录食管黏膜的变化。结果 A组套囊直径为(2.0±0.1)cm、套囊内压力为(125±25)cm H2O;B组套囊直径为(2.5±0.2)cm、套囊内压力为(140±32)cm H2O;C组套囊直径为(3.0±0.1)cm、套囊内压力为(165±36)cm H2O。A组3例返流、1例误吸;B组1例返流、无误吸;C组无返流和误吸。A1、A2、A3、B1组食管黏膜前后无变化;B2、B3、C1、C2组各有2例食管黏膜有充血样改变;C3组有1例发生食管黏膜水肿。结论套囊充气容量15-20ml时,预防误吸型胃管持续充气60min在急诊饱胃手术等高危误吸患者中的应用是安全有效的。Objective To evaluate the clinical outcomes of aspiration-prevented gastric tube （APGT）. Methods The APGT was applied in 45 patients with full stomach underwent emergency operation under general anesthesia, who were equally randomized into 3 groups of A（euff was filled with 10 ml air）, B（witb 15 ml air） and C（with 20 ml air）. Each group was then equally divided into 3 subgroups and the esophageal mucosa was inspected at 30 min（A1, B1,C1）, 60 min（A2, B2, C2） and 120 min（A3,B3 C3）. Results The diameter and inside pressure of cuff were （2.5±0. 2） em and （140 ±32） cmH20 in group A,which were （2.5±0.2） cm and （1404-32） cmHzO in group B, and were （3.0±0. 1） cm and （165 ± 36） cm H2O in group C, respectively. The regurgitation occurred in 3 cases of group A and in 1 case of group B. Aspiration was found in 3 cases of group A and 1 case of group 13. There was no any case with regurgitation or aspiration in group C. No aspiration was seen in group B. There was no change in esophageal mucosa in groups of A1, A2, A3 and B1. The esophageal mucosal hyperemia was observed in 2 cases in groups of B2, B3, C1 and C2. The esophageal mucosa edema occurred in 1 case of group C3. Conclusion Aspiration-prevented gastric tube can be safely used in the patients with full stomach, in whom regurgitation and aspiration can be prevented effectively with the optimal cuff capacity of 15 to 20 ml for not longer than 60 min.

关 键 词：胃管 饱胃 返流 误吸 全麻 

分 类 号：R614[医药卫生—麻醉学]