改良逆行气管插管技术在困难气道中的应用  

Use of modified retrograde endotracheal intubation in difficult airway patients

作　　者：范昊哲 陈琨[1] 童洪杰[1] Fan Haozhe;Chen Kun;Tong Hongjie(Department of Critical Care Medicine,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市中心医院重症医学科,浙江金华321000

出　　处：《中国中西医结合急救杂志》2019年第3期299-301,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省医药卫生科技计划项目(201465947).

摘　　要：目的分析改良逆行气管插管技术的优点并观察其在困难气道开放中的应用效果.方法选择2013年6月至2017年6月在金华市中心医院进行改良逆行气管插管的困难气道患者18例,统计插管成功率、并发症发生率、平均插管时间,并进行典型病例分析.结果18例困难气道患者中舌体肥大声门暴露困难7例,破伤风致牙关紧闭2例,颈髓损伤5例,烧伤4例.18例困难气道患者行改良逆行气管插管的成功率为100%,仅有1例发生穿刺点出血,经局部按压后改善,并发症发生率为5.6%(1/18),平均插管时间(3.6±0.8)min.结论改良逆行气管插管技术易于掌握,器材简单易得,成功率高,并发症少,适合在基层医院推广.Objective To analyze the advantages of modified retrograde endotracheal intubation and to investigate its application effect in difficult airway opening. Methods Eighteen patients with difficult airways receiving modified retrograde endotracheal intubation admitted to Jinhua Municipal Central Hospital from June 2013 to June 2017 were enrolled. The successful intubation rate, complication rate, average intubation time and typical cases were calculated and analyzed. Results The causes of airway difficulty in 18 patients: there were 7 patients with glottis exposing difficulty due to tongue body hypertrophy, 2 patients with trismus due to tetanus, 5 patients with cervical spinal cord injury and 4 patients with burns. The successful rate of modified retrograde endotracheal intubation was 100% in 18 patients with difficult airway. Only 1 patient had a little bleeding at the puncture site and it was improved after local compression, the complication rate being 5.6%(1/18), and the average intubation time was (3.6±0.8) min. Conclusion Modified retrograde endotracheal intubation is a method easy to be mastered, its material is simple and easily to be acquired, clinically, the successful rate in its application in difficult airway patients is very high and its incidence of complication is very low, so that the technique can be popularized in primary hospitals.

关 键 词：改良逆行气管插管 困难气道 环甲膜穿刺术 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]