我国麻醉医师对新型冠状病毒肺炎患者实施气管插管术的现状调查  

Investigation on current status of tracheal intubation performed by Chinese anesthesiologists for patients with coronavirus disease 2019

作　　者：李宁涛[1] 孙铭阳[1] 张维佳 阮孝国[1] 苌恩强 丛旭晖 左明章[2] 张加强[1] Li Ningtao;Sun Mingyang;Zhang Weijia;Ruan Xiaoguo;Chang Enqiang;Cong Xuhui;Zuo Mingzhang;Zhang Jiaqiang(Department of Anesthesiology and Perioperative Medicine,Henan Province People′s Hospital,Zhengzhou 450008,China;Department of Anesthesiology,Beijing Hospital National Center of Gerontology,Beijing 100730,China)

机构地区：[1]河南省人民医院麻醉与围术期医学科,郑州450008 [2]北京医院麻醉科,100730

出　　处：《中华麻醉学杂志》2020年第11期1300-1303,共4页Chinese Journal of Anesthesiology

摘　　要：目的采用问卷形式调查我国麻醉医师对新型冠状病毒肺炎(COVID-19)患者实施气管插管术的现状。方法采用自行设计的电子问卷,通过微信平台方式对为COVID-19患者实施气管插管术的麻醉医师进行问卷调查,调查时间从2020年2月18日至3月13日。结果共发放调查问卷120份,收到116份问卷调查,回收率为96.7%。剔除4份无效问卷,有效问卷共112份,有效率为96.6%。参与问卷调查的麻醉医师分布于全国18个省市,其中来自于三级医院的比率为77.7%,二级医院的比率为22.3%,工作年限大于10年的比率为75.9%。行治疗气管插管术的比率为63.4%,行急救气管插管术的比率为36.6%。采取三级防护的比率为76.8%,三级医院采取三级防护的比率高于二级医院(P<0.05)。麻醉医师采用Mallampati分级对患者进行气道评估的比率为63.4%,采用询问困难气道史、检查颈椎活动情况、测量颏甲间距和门齿间距的方法进行气道评估的比率高于采用Mallampati分级的比率(P<0.05)。麻醉医师采用快速序贯诱导气管插管的比率为24.1%,使用可视化气管插管工具的比率为94.6%,一次气管插管成功的比率为96.4%。气管插管前使用肌松药的比率为81.2%,与未用肌松药相比,使用肌松药明显提高一次气管插管成功的比率(P<0.05)。结论目前我国麻醉医师在三级防护下为COVID-19患者行气管插管术尚未完全普及;快速序贯诱导气管插管方式使用率较低;可视化气管插管工具应用广泛;使用肌松药气管插管更适用于该类患者。Objective To investigate the current status of tracheal intubation performed by Chinese anesthesiologists for the patients with coronavirus disease 2019(COVID-19)by using a questionnaire.Methods A self-designed questionnaire was used to carry out a questionnaire survey of anesthesiologists performing tracheal intubation for the patients with COVID-19 through the WeChat platform.The survey time was from February 18 to March 13,2020.Results A total of 120 questionnaires were distributed and 116 questionnaires were received,with a recovery rate of 96.7%.Four invalid questionnaires were eliminated,and 112 valid questionnaires were collected,with a valid rate of 96.6%.The anesthesiologists participating in the questionnaire survey were distributed in 18 provinces and cities across the country.Among them,the rate from tertiary hospitals was 77.7%,the rate from secondary hospitals was 22.3%,and the rate for working more than 10 yr was 75.9%.The rate of endotracheal intubation for therapy was 63.4%,and the rate of emergency endotracheal intubation was 36.6%.The rate of adopting tertiary protection was 76.8%,and the rate of adopting tertiary protection in tertiary hospitals was higher than that in secondary hospitals(P<0.05).The rate of airway assessment by anesthesiologists using Mallampati grading was 63.4%,and the rate of airway assessment using the methods of asking about a history of difficult airways,checking for cervical vertebra movement,and measuring the chin-plate spacing and incisor-tooth spacing was higher than that of Mallampati grading(P<0.05).The rate of rapid sequence induction and intubation by anesthetists was 24.1%,the rate of using visual endotracheal intubation tools was 94.6%,and the success rate of intubation at first attempt was 96.4%.The rate of using muscle relaxants before intubation was 81.2%.Compared with the rate of no use of muscle relaxants,the use of muscle relaxants significantly increased the success rate of intubation at first attempt(P<0.05).Conclusion Tracheal intubation performed by

关 键 词：新型冠状病毒肺炎 插管法 气管内 调查和问卷 

分 类 号：R614[医药卫生—麻醉学]