改良鼻腔探测导管在经鼻气管插管中应用的效果观察  

Effect of Improved Nasal Probe Catheter for the Transnasal Endotracheal Intubation on Patients

作　　者：曾金[1] 梁予洁 彭俊华[1] 段宇非 覃慧娟 ZENG Jin;LIANG Yu jie;PENG Jun hua;DUAN Yu fei;QIN Hui juan(Department of Anesthesiolongy,Liuzhou General Hospital,Liuzhou,Guangxi Zhuang Autonomous Region China,545006)

机构地区：[1]柳州市人民医院麻醉科,广西柳州545006

出　　处：《临床医药文献电子杂志》2020年第70期8-10,共3页Electronic Journal of Clinical Medical Literature

基　　金：广西壮族自治区卫生和计划生育委员会科研项目(Z20170697)。

摘　　要：目的观察采用改良鼻腔探测导管用于经鼻气管插管的安全性和效果。方法以改良具有专利号的鼻腔探测导管用于预估鼻腔通道内径并选择合适的气管导管进行经鼻气管插管(探测导管专利号:ZL 201620033792.7,以导管内径ID 4.0 mm的普通气管导管作为改良探测导管,导管前端套囊适量充气能通过鼻腔时,导管套囊的直径视为能通过的目标导管的直径)与按照常规以年龄、身高和发育情况选择插入导管内径的经鼻气管插管方法的全麻手术患者共120例,男66人、女54人,年龄22~75岁,ASA I级或II级,BMI 18~30 kg/m^2,随机分为两组,探测导管P组和常规对照C组,每组各60例。观察两组患者在4个时点(T0、T1、T2、T3)MAP、PR、SpO2的变化;观察两组选择目标导管一次选择的成功率和插管过程中鼻腔粘膜明显损伤出血的发生率。结果两组患者在T1时点的PR和MAP之值的组内比较明显高于其它时点(P<0.05)。两组同一时点的PR、MAP组间比较以及两组组内、组间的SpO2值比较,均无统计学差异(P>0.05)。P组选择目标导管一次选择的成功率明显高于C组(100%V.S 75%,P<0.05)。气管插管时P组鼻粘膜损伤出血的发生率明显低于C组(8.3%V.S 35%,P<0.05)。结论以改良探测导管用于探测鼻腔直径选择目标导管用于经鼻气管插管的方法,安全、可靠、鼻粘膜损伤出血的发生率低,值得临床应用。Objective T0 investigate the safety and effect of improved nasal probe catheter for the endotracheal intubation.Methods The improved nasal probe catheter was used to estimate the internal diameter of the nasal passageway(Patent number of the probe catheter:ZL 201620033792.7,The ordinary tracheal catheters with 4.0 millimeters internal diameter were replaced for the patent probe catheters,which could successively pass the nasal cavity with the cuff filled with a certain amount of air.The internal diameter of the cuff indicated the target catheter’s internal diameter for intubation).120 patients,including 66 males and 54 females,undergoing general anesthesia,ASA I or II,aged from 22 to 75 years,with BMI from 18 to 30 kg/m^2,were randomly divided into two groups,60 cases in each group.Patients in group P received the transnasal endotracheal intubation according to the proper ID of tracheal catheters by means of the improved nasal probe catheters(ID 4.0 mm)while The patients in group C received the transnasal endotracheal intubation with traditional methods according to their ages,heights and developmental conditions.The changes of MAP,PR and SpO2 were recorded at T0-T3(T0,T1,T2 and T3)in two groups.The success rate of one-time selection of the target catheter and the incidence of bleeding caused by injury to the nasal mucosa during intubation were observed.Results The values of PR and MAP at T1 were higher than those of else time points(T0,T2 and T3)in each group(P<0.05).There was no significant difference in PR and MAP between two groups at T1 and T3 in PR and MAP(P>0.05).There was no obvious difference in PR and MAP at the same time point between the two groups(P>0.05).There were no significant difference in SpO2 at each point in one group or between two groups(P>0.05).The success rate of one-time selection for target catheter in group P was obviously higher than those in group C(100%V.S 75%,P<0.05).The incidence of bleeding due to nasal mucosal injury in group P was significantly lower than those in group C(8.3

关 键 词：改良探测导管 经鼻气管插管 鼻粘膜损伤出血 并发症防治 

分 类 号：R4[医药卫生—临床医学]