广西公立医院困难气道管理现状调查与分析  

Investigation and analysis of current status of difficult airway management in Guangxi public hospitals

作　　者：张曼清 谢玉波[1] 陈秋妙 韦萍 王维 施小彤 ZHANG Manqing;XIE Yubo;CHEN Qiumiao;WEI Ping;WANG Wei;SHI Xiaotong(Department of Anesthesiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;Department of Surgical Anesthesiology,Guangxi Medical University College of Stomatology,Affiliated Stomatology Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;Department of Anesthesiology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,Guangxi,China)

机构地区：[1]广西医科大学第一附属医院麻醉科,广西南宁市530021 [2]广西医科大学口腔医学院/附属口腔医院手术麻醉科,广西南宁市530021 [3]广西医科大学第二附属医院麻醉科,广西南宁市530007

出　　处：《广西医学》2023年第24期3018-3023,共6页Guangxi Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2021083);中华口腔医学会青年临床科研基金口腔麻醉研究项目(CSA-A2021-08)。

摘　　要：目的 了解广西各级公立医院困难气道管理的现状。方法 自制调查问卷,利用腾讯问卷调查平台对广西二级及以上公立医院麻醉医师进行调查,了解其对困难气道管理的知晓及处理情况。结果 共收到广西126家公立医院共637名麻醉医师的有效问卷。手术间与麻醉医师的比例中,三级医院为1∶1.47,二级医院为1∶1.14;手术间与呼气末二氧化碳监护仪的比例中,三级医院为1∶0.94,二级医院为1∶0.72。麻醉医师遇见的困难气道的主要原因和类型依次为张口受限(92.5%,589/637)、肥胖(90.7%,578/637);常用的气道评估方法依次为张口度(83.0%,529/637)、困难气道病史(79.0%,503/637);43.8%(279/637)麻醉医师有过处理无法插管且无法通气的紧急情况的经验;13.5%(117/126)的公立医院发生过因困难气道导致的患者死亡或脑损伤;50.0%(63/126)的公立医院发生过因困难气道而取消手术的情况;95.8%(610/637)麻醉医师认为有必要告知患者困难气道相关信息,但仅29.5%(188/637)麻醉医师了解困难气道告知书。结论 广西公立医院麻醉医师短缺,困难气道告知的普及率偏低,仍有部分麻醉医师对困难气道处理认知不足或处理不当,需加强其对困难气道的培训,提升困难气道的处理能力。Objective To understand the current status of difficult airway management in Guangxi public hospitals at all levels.Methods The investigation questionnaire was self-made,and Tencent questionnaire investigation platform was used to perform investigation on anesthesiologists in Guangxi class two and above public hospitals;in addition,their awareness and treatment of difficult airway management were understood.Results A total of 637 valid questionnaires were received from 126 Guangxi public hospitals.The ratio of operating room to anesthesiologists was 1∶1.47 in class three hospitals and 1∶1.14 in class two hospitals;furthermore,the ratio of operating room to end-tidal carbon dioxide monitor was 1∶0.94 in class three hospitals and 1∶0.72 in class two hospitals.The most common causes and types of difficult airway encountered by anesthesiologists were limited mouth opening(92.5%,589/637)and obesity(90.7%,578/637),and the most common airway assessment methods were mouth opening(83.0%,529/637)and difficult airway history(79.0%,503/637).A total of 43.8%(279/637)of the anesthesiologists had experience in dealing with emergency situations in which patents could not be intubated or ventilated,death or brain injury caused by difficult airway occurred in 13.5%(117/126)of public hospitals,50%(63/126)of public hospitals had cancelled surgery due to difficult airway,and 95.8%(610/637)of anesthesiologists thought it was necessary to inform patients about the difficult airway,but only 29.5%(188/637)of anesthesiologists understood the difficult airway notification.Conclusion There is still a shortage of anesthesiologists in Guangxi public hospitals.The penetration rate of difficult airway notification is on the low side,and there are still some anesthesiologists with insufficient knowledge or improper handling of difficult airway.It is necessary to strengthen their training on difficult airway and improve their ability to deal with difficult airway.

关 键 词：气道管理 困难气道 问卷调查 困难气道告知 

分 类 号：R197[医药卫生—卫生事业管理]