鼻咽通气管在无抽搐电休克治疗气道管理中的应用  

The Application of Nasopharyngeal Airway in Airway Management of Modified Electroconvulsive Therapy

作　　者：孙明[1,2] 孙明明 王凤芹 王庆辉[4] 董河 SUN Ming;SUN Mingming;WANG Fengqin;WANG Qinghui;DONG He(The Affiliated Hospital of Qingdao University,Qingdao 266000,China;不详)

机构地区：[1]青岛大学附属医院,山东青岛266000 [2]山东省枣庄市精神卫生中心 [3]山东省潍坊市精神卫生中心 [4]山东省枣庄市妇幼保健院

出　　处：《中国医学创新》2023年第27期157-161,共5页Medical Innovation of China

摘　　要：目的:评价鼻咽通气管在无抽搐电休克治疗(modified electroconvulsive therapy,MECT)中改善精神疾病患者的通气效果。方法:选取2019年12月—2021年12月在枣庄市精神卫生中心住院并进行MECT治疗的150例精神疾病患者,按随机数字表法分为面罩通气组(M组)、口咽通气道通气组(O组)和鼻咽通气管通气组(N组)。患者在静脉推注丙泊酚和琥珀酰胆碱后,M组给予常规单纯面罩通气,O组给予置入口咽通气道后面罩通气,N组给予置入鼻咽通气管后面罩通气。比较三组气道压力值、血氧饱和度(saturation of peripheral oxygen,SpO_(2))、平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、呼吸恢复时间、意识恢复时间及耐受时间。结果:麻醉后(T_(1)),N组和O组气道压力均低于M组,差异均有统计学意义(P<0.05);N组和O组气道压力比较,差异有统计学意义(P<0.05)。通电后1 min(T_(2))和通电后3 min(T_(3)),M组、N组HR、MAP均明显低于O组,M组患者SpO_(2)明显低于O组、N组,差异均有统计学意义(P<0.05)。N组和O组患者呼吸恢复时间、意识恢复时间均短于M组,差异均有统计学意义(P<0.05);N组患者耐受时间长于O组,差异有统计学意义(P<0.05)。结论:鼻咽通气管和口咽通气道在精神疾病患者进行MECT治疗时均能解除患者上呼吸道梗阻,缩短呼吸和意识的恢复时间。鼻咽通气管具有更好的耐受性及血流动力学稳定性,减缓患者痛苦,增加了安全性。Objective:To evaluate the effect of nasopharyngeal airway on improving ventilation of patients with psychiatric disorders during modified electroconvulsive therapy(MECT).Method:A total of 150 psychiatric disorders patients hospitalized in Zaozhuang Mental Health Center and treated with MECT from December 2019 to December 2021 were divided into mask ventilation group(group M),oropharyngeal airway ventilation group(group O)and nasopharyngeal airway ventilation group(group N)according to random number table method.After intravenous injection of Propofol and Succinylcholine,group M was given routine simple face mask ventilation.Group O was given ventilation with a mask placed behind the oropharyngeal airway,while group N was given ventilation with a mask placed behind the nasopharyngeal airway.The airway pressure values,the oxygen saturation(SpO_(2)),mean arterial pressure(MAP),heart rate(HR),respiratory recovery time,consciousness recovery time and tolerance time were compared among the three groups.Result:After anesthesia(T_(1)),the airway pressure of patients in group N and O were lower than those in group M,the differences were statistically significant(P<0.05);there was significant difference in airway pressure between group N and group O(P<0.05).1 min after electrification(T_(2))and 3 min after electrification(T_(3)),the HR and MAP of patients in group M and N were significantly lower than those in group O,while the SpO_(2) of patients in group M was significantly lower than those in group N and O,the differences were statistically significant(P<0.05).The respiratory recovery time and consciousness recovery time of group N and O were shorter than those in group M,the differences were statistically significant(P<0.05);The tolerance time in group N was longer than that in group O,the difference was statistically significant(P<0.05).Conclusion:Both nasopharyngeal airway and oropharyngeal airway can relieve upper respiratory obstruction and shorten the recovery time of breathing and consciousness in patients with p

关 键 词：鼻咽通气管 口咽通气道 无抽搐电休克 通气 麻醉 

分 类 号：R614[医药卫生—麻醉学]