新型经鼻气管插管固定器在头颈外科手术中的应用评价  

Evaluation of the application of a new type nasotracheal intubation fixation device in head and neck surgery

作　　者：田昊[1] 吴珺[1] TIAN Hao;WU Jun(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,100050

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第4期298-302,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨一种新型经鼻气管插管固定装置在头颈外科手术中的应用效果。方法选取2020年6月~2021年4月在我院中心手术室经鼻气管插管全身麻醉手术的成年患者180例,采用随机数字表法分成观察组和对照组,每组90例。观察组采用自主研发的新型经鼻气管插管固定装置固(获得国家新型实用专利授权,专利号:ZL 202020903995.3),对照组采用常规方法结合水胶体敷料固定。比较两组鼻部压力性损伤、呼吸管路松动的发生率,以及通过视觉模拟量表方法比较麻醉医生和手术室护士对两种固定方法的满意度。结果观察组患者鼻翼压力性损伤的发生率为3.33%(3/90),对照组为12.2%(11/90),观察组发生率明显低于对照组,差异有统计学意义(χ^(2)=5.149,P<0.05)。观察组患者中无一例发生因术中转变头位导致的呼吸通路过滤器与气管插管衔接口松动或脱落,对照组中共发生7次。麻醉科医护人员对两种固定方式的满意度调查,观察组医护人员平均得分为(8.0160.673),对照组平均得分(3.1731.006),观察组满意度高于对照组,得分有显著性统计学差异(t=6.245,P<0.05)。结论使用新型经鼻气管插管固定装置能显著降低鼻部压力性损伤的发生率,不增加其他部位的压力性损伤。并且能预防术中呼吸管路松动脱落,便于麻醉医护人员使用,值得在临床推广使用。Objective To explore the application effect of a new type of nasotracheal intubation fixation device in head and neck surgery.Methods 180 adult patients undergoing nasotracheal intubation general anesthesia of our hospital from June 2020 to April 2021 were randomly divided into experimental group(n=90)and control group(n=90).The experimental group was fixed with a new type of nasotracheal intubation fixation device developed by ourselves,and the control group was fixed with conventional method combined with hydrocolloid dressing.The incidences of nasal stress injury and respiratory tube loosening were compared between the two groups,and the satisfaction of anesthesiologists and operating room nurses to the two fixation methods were compared by visual analog scale.Results The incidence rate of nasal pressure injury in the test group was 3.33%(3/90),and that in the control group was 12.2%(11/90).The satisfaction of the experimental group was lower than that of the control group,and the incidence was significant Statistical difference(χ^(2)=5.149,P<0.05).No patient in the experimental group had any loosening or falling off of the breathing channel filter and endotracheal tube joint due to head position change during the operation,and there were 7 occurrences in the control group.The satisfaction survey of medical staff in the operating room on the two fixation methods,the average score of the medical staff in the experimental group was(8.0160.673),and the average score of the control group(3.1731.006),the satisfaction of the experimental group was higher than that of the control group,and the score was significant Statistical difference(t=6.245,P<0.05).Conclusion The use of the new nasotracheal intubation fixation device can significantly reduce the incidence of nasal pressure injury,and without increasing the pressure injury of other parts.It also can prevent the breathing tube from loosening and falling off during the operation,which is convenient for anesthesiologists and operating room nurses,and is worthy of c

关 键 词：经鼻气管插管 压力性损伤 头颈外科 鼻翼 

分 类 号：R614[医药卫生—麻醉学]