探讨达克罗宁胶浆润滑气管导管对困难气道纤维支气管镜引导下清醒气管插管中血流动力学、呛咳反应的影响  

To Investigate the Effects of Dacronin Grain-lubricated Tracheal Catheter on Hemodynamics and Cough Response in Awake Tracheal Intubation Under Fiberoptic Bronchoscopy Under Difficult Airway

作　　者：刘晓青 任斌 LIU Xiao-qing;REN Bin(Department of Anesthesiology,Linzhi People's Hospital,Linzhi 860100,China)

机构地区：[1]西藏自治区林芝市人民医院麻醉科

出　　处：《中国医药指南》2019年第16期17-18,共2页Guide of China Medicine

摘　　要：目的探讨达克罗宁胶浆润滑气管导管对困难气道纤维支气管镜引导下清醒气管插管中血流动力学、呛咳反应的影响。方法将2014年1月至2019年2月在我院行困难气道纤维支气管镜引导下清醒气管插管的619例患者按气管导管润滑方法不同分为两组,对照组300例采用石蜡油润滑气管导管,观察组319例采用达克罗宁胶浆润滑气管导管,比较两组患者的气管插管前后血流动力学变化,气管拔管前后血流动力学变化,呛咳、躁动等不良反应发生率。结果插管时观察组心率、收缩压、舒张压明显低于对照组,血氧饱和度明显高于对照组,插管后观察组收缩压、舒张压低于对照组(P<0.05),而心率、血氧饱和度无明显差异(P>0.05);拔管前两组心率及平均动脉压无明显变化(P>0.05),拔管时及拔管后的心率、平均动脉压明显低于对照组(P<0.05);观察组插管反应、呛咳、躁动等不良反应发生率明显低于对照组(P<0.05)。结论达克罗宁胶浆润滑气管导管对困难气道纤维支气管镜引导下清醒气管插管效果显著,能有效平稳插管及拔管前后的血流动力学,减少呛咳等不良反应发生,具有积极的临床意义。Objective To investigate the effects of dacronin grain-lubricated tracheal没没有catheter on hemodynamic and choke-cough reactions in awake tracheal intubation under the guidance of fiberoptic bronchoscopy for difficult airway.Methods From January 2014 to February 2019 in our hospital difficult airway guided by fiber bronchoscope conscious endotracheal intubation of 619 patients were divided into two groups by the endotracheal tube lubrication method,the control group,300 cases with paraffin oil lubrication the endotracheal tube,observation group of 319 patients with tak Luo Ningjiao slurry lubrication endotracheal tube,compared two groups of patients with tracheal intubation hemodynamic changes before and after,hemodynamic changes before and after tracheal extubation,incidence of adverse reactions such as choke to cough,agitated.Results During intubation,heart rate,systolic blood pressure and diastolic blood pressure in the observation group were significantly lower than those in the control group,and blood oxygen saturation was significantly higher than that in the control group.After intubation,systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group(P<0.05),while heart rate and blood oxygen saturation showed no significant difference(P>0.05).There was no significant change in heart rate and average arterial pressure between the two groups before and after extubation(P>0.05),while heart rate and average arterial pressure during and after extubation were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions such as intubation reaction,cough and agitation in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Dacronine-lubricated tracheal catheter has significant effect on awake tracheal intubation under the guidance of fiberoptic bronchoscopy in difficult airway,can effectively stabilize the hemodynamics before and after intubation and extubation,and reduce adver

关 键 词：困难气道纤维支气管镜引导下清醒气管插管 气管导管润滑 达克罗宁胶浆 血流动力学 呛咳反应 

分 类 号：R56[医药卫生—呼吸系统]