摘要
目的研究七氟醚联合纤支镜引导下表面麻醉在困难气道气管插管中的临床应用效果。方法方便选择2019年2月—2020年2月该院接受治疗的132例行手术时困难气道患者进行该次研究,按照抽签法分为研究组和对照组各66例,对照组采用右美托咪定联合纤支镜引导插管,研究组采用七氟醚联合纤支镜引导插管。比较入手术室后(T_(0))、气管导管进鼻腔前(T_(1))、气管导管入声门即刻(T_(2))及插管成功后(T_(3))两组平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))和Ramsay镇静评分,满意度、舒适度,刺激反应。结果治疗后,两组均成功插管,两组T_(0)、T_(3)时MAP、HR、SpO_(2),差异无统计学意义(P>0.05),T_(2)时MAP、HR明显低于对照组[(71.78±3.67)mmHg vs(85.97±5.71)mmHg,(75.42±3.56)次/min vs(90.12±5.86)次/min],差异有统计学意义(t=14.947、15.351,P<0.001);研究组气管导管进鼻腔前(T_(1))、气管导管入声门即刻(T_(2))时Ramsay镇静评分高于对照组[(4.61±0.92)分vs(2.69±0.78)分,(3.59±0.53)分vs(2.30±0.51)分],差异有统计学意义(t=12.932、14.248,P<0.001);研究组满意度、舒适度均显著低于对照组[(1.36±0.21)分vs(2.97±0.35)分,(3.03±0.60)分vs(3.28±0.69)分],差异有统计学意义(t=32.045、2.221,P<0.001);研究组刺激反应总发生率(9.09%)显著低于对照组(22.73%),差异有统计学意义(χ^(2)=4.587,P=0.032)。结论七氟醚较右美托咪定与纤支镜引导表面麻醉的效果更好,可有效保持困难气道患者在气管插管时自主呼吸,稳定生命体征,减少刺激。
Objective To study the clinical effect of sevoflurane combined with bronchoscopy-guided topical anesthesia in difficult airway and endotracheal intubation.Methods A total of 132 patients with difficult airway during surgery who were treated in the hospital from February 2019 to February 2020 were conveniently selected for the study.According to the lottery method,they were divided into the study group and the control group with 66 cases in each.The control group was treated with dexmedetomidine combined with fiberoptic bronchoscopy for guided intubation,while the study group was treated with sevoflurane combined with fiberoptic fiberoptic guided intubation.The mean arterial pressure(MAP),heart rate(HR),blood pressure and blood pressure were compared between the two groups after entering the operating room(T_(0)),before the endotracheal tube was inserted into the nasal cavity(T_(1)),immediately after the endotracheal tube was inserted into the glottis(T_(2))and after successful intubation(T_(3)),Oxygen saturation(SpO_(2)).and Ramsay sedation score,satisfaction,comfort,stimulus response.Results After treatment,both groups were successfully intubated,and there was no statistically significant difference in MAP,HR and SpO_(2) between the two groups at T_(0) and T_(3)(P>0.05).At T_(2),MAP and HR were significantly lower than those in the control group[(71.78±3.67)mmHg vs(85.97±5.71)mmHg,(75.42±3.56)times/min vs(90.12±5.86)times/min],the difference was statistically significant(t=14.947,15.351,P<0.001).The Ramsay sedation score of the study group before the endotracheal tube was inserted into the nasal cavity(T_(1))and immediately after the endotracheal tube was inserted into the glottis(T_(2)),higher than the control group[(4.61±0.92)points vs(2.69±0.78)points,(3.59±0.53)points vs(2.30±0.51)points],the difference was statistically significant(t=12.932,14.248,P<0.001).The satisfaction and comfort of the research group were significantly lower than those of the control group[(1.36±0.21)points vs(2.97±0.35)points,(3.03±0.60)points vs(3.28±0.69)points],the difference was statistically significant(t=32.045,2.221,P<0.001).The total incidence of stimulus response in the study group(9.09%)was significantly lower than that in the control group(22.73%),and the difference was statistically significant(χ^(2)=4.587,P=0.032).Conclusion Sevoflurane is more effective than dexmedetomidine and bronchoscopy-guided topical anesthesia,which can effectively keep patients with difficult airways breathing spontaneously during tracheal intubation,stabilize vital signs,and reduce irritation.
作者
邱少钊
QIU Shaozhao(Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian Province,361004 China)
出处
《中外医疗》
2022年第10期90-93,98,共5页
China & Foreign Medical Treatment
关键词
七氟醚
纤支镜引导
表面麻醉
困难气道
气管插管
Sevoflurane
Bronchoscopy guidance
Topical anesthesia
Difficult airway
Tracheal intubation
