"工"形胶布固定法用于小儿扁桃体和腺样体手术气管导管固定的效果分析  

Effect of"工"type adhesive tape fixation method on tracheal tube fixation in children's adenoids and tonsils surgery

作　　者：李正钢[1] 吴秀英[1] 薛玉红 Li Zhenggang;Wu Xiuying;Xue Yuhong(Department of Anesthesiology,Shengjing Hospital of China Medical University,Shenyang 110000,China;Department of Nephrology,Shengjing Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110000 [2]中国医科大学附属盛京医院肾内科,沈阳110000

出　　处：《中国医师进修杂志》2020年第1期66-69,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨"工"形胶布固定法在小儿扁桃体和腺样体手术中气管导管固定的效果。方法选择2019年1—6月中国医科大学附属盛京医院择期行扁桃体和腺样体手术患儿80例,按随机数字表法分为对照组和试验组,每组40例。对照组术中气管导管固定采用传统的双胶布固定法,试验组术中气管导管固定采用"工"形胶布固定法。用软尺记录气管导管固定好后、置入开口器、手术结束时导管距右侧口角的刻度,作为判断气管导管移位指标;记录脱管和胶布附着处皮肤受损情况。结果试验组气管导管固定好后至置入开口器和气管导管固定好后至手术结束气管导管移位距离明显小于对照组[(0.38±0.16)cm比(0.74±0.25)cm和(0.51±0.20)cm比(1.69±0.51)cm],差异有统计学意义(t=7.67和13.62,P<0.05)。两组脱管发生率比较差异无统计学意义(P>0.05)。两组患儿均未发生压疮;两组破损发生率比较差异无统计学意义(P>0.05);试验组红肿和总皮肤受损发生率明显低于对照组[20.0%(8/40)比55.0%(22/40)和20.0%(8/40)比62.5%(25/40)],差异有统计学意义(χ^2=13.07和14.90,P<0.01)。结论"工"形胶布固定法用于小儿扁桃体和腺样体手术中气管导管的固定操作简单,固定牢固,能有效减少气管导管的移位,同时对皮肤的损伤程度更小。Objective To investigate the effect of"工"type adhesive tape fixation method on tracheal tube fixation in children′s adenoids and tonsils surgery.Methods Eighty children who underwent selective adenoids and tonsils surgery from January to June 2019 in Shengjing Hospital of China Medical University were selected.The children were divided into control group and experimental group by random digits table method with 40 cases each.The tracheal tube of control group was fixed by traditional double-adhesive tape fixation method,and the tracheal tube of experimental group was fixed by"工"type adhesive tape fixation method.The distance between tracheal tube and right corner of mouth at the time of tracheal tube fixation,mouth opener insertion and the end of surgery by a soft ruler were recorded as an index of tracheal tube displacement.The detubation and skin damage were also recorded.Results The displacement distances of tracheal tube from tracheal tube fixation to mouth opener insertion and from tracheal tube fixation to the end of surgery in experimental group were significantly smaller than those in control group:(0.38±0.16)cm vs.(0.74±0.25)cm and(0.51±0.20)cm vs.(1.69±0.51)cm,and there were statistical differences(t=7.67 and 13.62,P<0.05).There was no statistical difference in the incidence of detubation between 2 groups(P>0.05).The pressure ulcers did not occur in 2 groups;there was no statistical difference in the incidence of breakage between 2 groups(P>0.05);the incidences of redness and total skin damage in experimental group were significantly lower than those in control group:20.0%(8/40)vs.55.0%(22/40)and 20.0%(8/40)vs.62.5%(25/40),and there were statistical differences(χ^2=13.07 and 14.90,P<0.01).Conclusions The"工"type adhesive tape fixation method is used for the fixation of tracheal tube in adenoids and tonsils surgery in children,which is easy to operate and fixes firmly,and can effectively reduce the displacement of tracheal tube and reduce the degree of skin damage.It is worthy of clinical app

关 键 词：扁桃体切除术 腺样体切除术 插管法 气管内 麻醉 "工"形胶布 

分 类 号：R726[医药卫生—儿科]