不同方法用于气管插管全麻患者术中胃管置入的比较  

Comparison of Different Methods for Nasogastric Tube Insertion in Patients with Tracheal Intubation under General Anesthesia

作　　者：赵玉斌 屈启才[2] 思永玉[2] ZHAO Yu-bin;QU Qi-cai;SI Yong-yu(Dept .of Anesthesiology,The First People's Hospital of Qujing City,Qujing Yunnan 655000;Dept .of Anesthesiology,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]曲靖市第一人民医院麻醉科,云南曲靖655000 [2]昆明医科大学第二附属医院麻醉科,云南昆明650101

出　　处：《昆明医科大学学报》2019年第8期93-96,共4页Journal of Kunming Medical University

基　　金：云南省卫生系统学科带头人基金资助项目(D-201213)

摘　　要：目的探讨3 种方法用于气管插管全麻患者术中胃管置入的成功率及并发症。方法选择135 例择期行普外科手术、气管插管全麻的患者,ASAⅠ~Ⅱ级,随机分为3 组:A 组盲探下插入胃管,B 组在普通喉镜辅助下插入胃管,C 组在可视喉镜下置入胃管,每组45 例。3 组胃管放置前均用盐酸达克罗宁胶浆润滑。记录胃管置入的1 次、2 次、3 次成功率及1 次成功置入的时间、记录胃管置入后患者口咽部出血、胃管打结等不良情况。结果3 组病人成功置入胃管的1 次、2 次、3 次成功率差异有统计学意义(P<0.05)。一次成功置管时间,3组分别为(36.9±9.6) s、(25.0±8.0) s、(20.2±5.0) s,C 组置管时间最短,差异有统计学意义(P<0.01);A 组、B 组、C 组分别有12 例(26.7%),5 例(11.1%),7 例(15.6%)发生咽部出血,差异无统计学意义(P>0.05)。结论可视喉镜引导下放置胃管对病人咽部损伤小、成功率高、胃管置入时间短,值得临床推广应用。Objective To investigate the success rate and complication of nasogastric tube insertion in patients with tracheal intubation under general anesthesia. Methods 135 patients,ASAⅠorⅡ,undergoing elective general surgery with tracheal intubation under general anesthesia, were randomly divided into three groups: no assisting device was used to insert gastric tube in the control group (group A), using direct macintosh laryngoscope assistance(group B),using GlideScope visualization assistance (group C),45 cases in each group. Before the placement of the gastric tubes in the 3 groups, dacronine hydrochloride was used to lubricate. The nostril used for nasogastric tube insertion was relatively unobstructed. The one-time, two-time and three-time success rate of nasogastric tube insertion and the time of the first successful insertion were recorded. Patients with pharyngeal hemorrhage and gastric tube knot were recorded after nasogastric tube insertion. Results There were statistically significant differences in the 1, 2 and 3-time of nasogastric tube insertion among the three groups of patients (P< 0.05). The time of the first successful insertion was(36.9±9.6) s,(25.0±8.0) s,(20.2±5.0) s respectively, and the time of insertion in group C was the shortest (P<0.01). There were 12 (26.7%), 5 (11.1%) and 7 (15.6%) cases of pharyngeal hemorrhage in group A,B and C respectively, with no statistically significant differences(P>0.05). Conclusion Nasogastric tube placement under the guidance of video laryngoscope has little damage to patients' pharynx, high success rate and short duration of gastric tube placement, which is worthy of clinical application.

关 键 词：全身麻醉 气管插管 胃管放置 可视喉镜 

分 类 号：R614[医药卫生—麻醉学]