左侧卧位下气管插管在食管-胃底静脉曲张出血内镜治疗中应用  

Application of tracheal intubation in left lateral position in endoscopic treatment of esophageal and gastric variceal bleeding

作　　者：侯铁柱 张加强 郑改芳 胡振华 吕素平 刘喆 刘胜群 HOU Tie-zhu;ZHANG Jia-qiang;ZHENG Gai-fang;HU Zhen-hua;LYU Su-ping;LIU Zhe;LIU Sheng-qun(Department of Anesthesialogy and Perioperative Medicine,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]郑州大学人民医院河南省人民医院麻醉与围术期医学科,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2022年第8期838-840,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(201303173)。

摘　　要：目的探讨食管-胃底静脉曲张出血患者左侧卧位下气管插管行内镜治疗的可行性和安全性。方法食管-胃底静脉曲张出血患者360例均行内镜治疗,根据气管插管体位分为左侧卧位组和仰卧位组各180例,麻醉诱导后分别以左侧卧位和仰卧位置入气管导管,行机械通气。记录2组张口度、Mallampati分级、摆体位时间、插管时间、插管次数、插管损伤和反流误吸发生情况。结果左侧卧位组摆体位时间[(0.5±0.3)min]短于仰卧位组[(3.2±1.5)min](t=12.150,P=0.024),反流误吸发生率(1.7%)低于仰卧位组(8.3%)(χ^(2)=14.210,P=0.016),张口度、Mallampati分级、插管时间、插管次数及插管损伤发生率与仰卧位组比较差异均无统计学意义(P>0.05)。结论左侧卧位下气管插管用于食管-胃底静脉曲张出血内镜治疗患者,可降低反流误吸发生率,缩短摆体位时间。Objective To evaluate the feasibility and safety of tracheal intubation in left lateral position in endoscopic treatment of esophageal and gastric variceal bleeding.Methods Totally 360 patients with esophageal and gastric variceal bleeding were performed endoscopy,and were equally divided into left lateral position group and supine position group.After anesthesia induction,tracheal tube was placed in corresponding position and mechanical ventilation was performed.The mouth opening degree,Malampati airway grading score,positioning time,intubation time,intubation frequency,intubation related injury and the occurrence of reflux aspiration were recorded in two groups.Results The time of positioning was shorter in left lateral position group[(0.5±0.3)min]than that in supine position group[(3.2±1.5)min](t=12.150,P=0.024),the incidence of reflux aspiration was lower in left lateral position group(1.7%)than that in supine position group(8.3%)(χ^(2)=14.210,P=0.016),and there were no significant differences in the mouth opening degree,Mallampati airway grading score,intubation frequency,intubation time and incidence of intubation related injury between two groups(P>0.05).Conclusion Tracheal intubation in left lateral position can reduce the occurrence of reflux aspiration and shorten the time of positioning in endoscopic treatment of esophageal and gastric variceal bleeding.

关 键 词：食管-胃底静脉曲张 左侧卧位 气管插管 内镜治疗 

分 类 号：R57[医药卫生—消化系统]