经鼻气管插管在全身麻醉俯卧位脊柱手术中的应用效果分析  

Analysis of the application effect of nasotracheal intubation in prone position spinal surgery under general anesthesia

作　　者：赵园园 袁浩 罗来林 ZHAO Yuanyuan;YUAN Hao;LUO Lailin(Department of Anesthesiology,Fuyang Hospital of Anhui Medical University,Fuyang,Anhui 236000,China)

机构地区：[1]安徽医科大学附属阜阳医院麻醉科,安徽阜阳236000

出　　处：《现代医药卫生》2025年第3期641-645,共5页Journal of Modern Medicine & Health

摘　　要：目的 分析经鼻气管插管在全身麻醉俯卧位脊柱手术中的应用效果。方法 选取2023年1月至2024年2月该院收治的拟行后路脊椎手术患者100例,采用随机数字表法分为观察组(经鼻气管插管)和对照组(经口气管插管),每组50例。记录2组患者麻醉诱导前(T0)、插管即刻(T1)、麻醉结束时(T2)、苏醒时(T3)平均动脉压和心率,以及苏醒时耐管反应、口唇压力性损伤、气管导管移位、气管导管受压/扭曲、咽喉疼痛不良事件发生情况等。结果 在俯卧位手术中2种插管方式均能提供良好的通气。与对照组比较,观察组患者T3时平均动脉压、心率、苏醒时耐管反应分级、口唇压力性损伤发生率、气管导管移位率均明显降低,差异均有统计学意义(P<0.05);2组患者气管导管受压/扭曲、咽喉疼痛发生率比较,差异均无统计学意义(P>0.05)。结论 在全身麻醉俯卧位脊柱手术中与经口气管插管比较,经鼻气管插管患者口唇压力性损伤、气管导管移位发生率较低,苏醒时耐管性好,有利于提高患者舒适度和麻醉安全性。Objective To analyze the effect of nasotracheal intubation in spinal surgery in prone position under general anesthesia.Methods A total of 100 patients admitted to the hospital from January 2023 to February 2024 who were to undergo posterior spinal surgery were selected and divided into an observation group(nasotracheal intubation)and a control group(orotracheal intubation)using a randomized numerical table method,with 50 patients in each group.Mean arterial pressure and heart rate before anesthesia induction(T0),at the immediate moment of intubation(T1),at the end of anesthesia(T2),and at the time of awakening(T3),as well as the occurrence of tube-resistant reactions,lip pressure injury,endotracheal tube displacement,endotracheal tube compression/twisting,and sore throat adverse events at the time of awakening in the patients of the two groups were recorded.Results Both intubation methods provided good ventilation during in prone position surgery.Compared with the control group,the mean arterial pressure,heart rate,tube-resistant response grading at awakening,the incidence of orofacial pressure injury,and the rate of tracheal tube displacement in the patients of the observation group were significantly lower at T3,and the differences were statistically significant(P<0.05).The incidence of tracheal tube compression/twisting,and pharyngolaryngeal pain in the patients of the two groups were compared,and the differences were not statistically significant(P>0.05).Conclusion In general anesthesia prone position spinal surgery compared with transoral intubation,patients with transnasal tracheal intubation have a lower incidence of orofacial pressure injury,tracheal tube displacement,and good tube tolerance at awakening,which is conducive to improving patient comfort and anesthesia safety.

关 键 词：经鼻气管插管 俯卧位 脊柱手术 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]