比较不同鼻孔路径下经鼻气管插管在五官科手术中的应用效果  

To compare the application effect of nasal tracheal intubation under diff erent nostril paths in ent surgery

作　　者：陈杰 CHEN Jie(Guiyi Anshun Hospital,Anshun Guizhou 561000)

机构地区：[1]贵医安顺医院,贵州安顺561000

出　　处：《当代医药论丛》2023年第14期43-46,共4页

摘　　要：目的:分析比较不同鼻孔路径下经鼻气管插管在五官科手术中的应用效果。方法:收集200例在贵医安顺医院五官科行经鼻气管插管手术的患者作为研究对象,采用随机数表法进行分组,分为左鼻孔组(n=100)和右鼻孔组(n=100)。左鼻孔组术中经左侧鼻孔插入气管导管,右鼻孔组术中经右侧鼻孔插入气管导管。插管成功后,通过呼气末二氧化碳水平及双肺听诊来确认气管导管的位置。对比两组的插管情况、并发症发生率、呼吸频率等指标。结果:(1)两组的导管通过鼻道时间、一次插管成功率及插管失败率相比,差异无统计学意义(P>0.05);右鼻孔组的插管时间短于左鼻孔组,插管辅助率低于左鼻孔组,差异有统计学意义(P<0.05)。(2)右鼻孔组鼻出血的发生率和程度均低于左鼻孔组,差异有统计学意义(P<0.05);两组咽痛、声音嘶哑、饮水呛咳、嗅觉丧失的发生率相比,差异无统计学意义(P>0.05)。(3)右鼻孔组插管过程中的呼吸频率低于左鼻孔组,血氧饱和度高于左鼻孔组,差异有统计学意义(P<0.05);两组插管过程中的动脉血气相比,差异无统计学意义(P>0.05)。结论:在五官科手术中,当患者左右鼻孔通气情况相同时,选择经右侧鼻孔进行气管插管可以降低插管相关的鼻出血率、出血严重程度及插管辅助率,并缩短插管时间,维持术中呼吸频率和血氧饱和度的稳定。然而,该结论只适用于左右鼻孔通气情况一致的情况,其他情况需要进一步探讨分析。Objective:To analyze and compare the application effect of nasal tracheal intubation under different nostril paths in ent surgery.Methods:200 patients undergoing nasal tracheal intubation in the ent departm ent of Anshun Hospital were collected and divided into left nostril group(n=100)and right nostril group(n=100)by random number table method.In the left nostril group,a tracheal catheter was inserted through the left nostril,and in the right nostril group,a tracheal catheter was inserted through the right nostril.After successful intubation,the position of the tracheal tube was confirmed by end-expiratory carbon dioxide level and auscultation of both lungs.The intubation condition,complication rate and respiratory rate were compared between the two groups.Results:(1)There were no significant differences in the passage time of the catheter through the nasal passage,the success rate of one intubation and the failure rate of intubation between the two groups(P>0.05).The intubation time in the right nostril group was shorter than that in the left nostril group,and the intubation assistance rate was lower than that in the left nostril group,with statistical significance(P<0.05).(2)The incidence and degree of nosebleed in the right nostril group were lower than those in the left nostril group,with statistical significance(P<0.05);There was no significant difference in the incidence of sore throat,hoarseness,cough and anosmia between the two groups(P>0.05).(3)The respiratory rate of the right nostril group during intubation was lower than that of the left nostril group,and the blood oxygen saturation was higher than that of the left nostril group,with statistical significance(P<0.05);There was no significant difference in arterial blood gas during intubation between the two groups(P>0.05).Conclusion:In the operation of ent department,when patients with the same ventilation condition from both sides of the nostril,endotracheal intubation through the right nostril can reduce the rate of intubation-related nose bleeding,

关 键 词：不同鼻孔路径 经鼻气管插管 五官科手术 并发症 

分 类 号：R614[医药卫生—麻醉学]