摘要
目的比较空肠营养管导丝辅助和可视喉镜下经空肠营养管导丝辅助两种改良技术与传统技术留置胃管置管成功率、置管时间和不良事件发生率方面的差异。方法选择2020年1月至2021年12月嘉兴市第一医院收治的60例重型颅脑损伤伴颅底骨折或鼻骨骨折、鼻出血的气管插管患者作为研究对象,将患者按随机原则分为空肠营养管导丝辅助组(在空肠营养管导丝辅助下经口留置胃管)、可视喉镜下导丝辅助组(可视喉镜下,在空肠营养管导丝辅助下经口留置胃管)和传统手法组(采用传统方法经口留置胃管),每组20例。观察3组置管成功率、置管时间和不良事件的发生情况。结果与传统手法组比较,可视喉镜下导丝辅助组第1次置管成功率明显升高〔90.0%(18/20)比40.0%(8/20),P<0.05〕,置管时间明显缩短(s:20.85±2.58比35.91±5.07,P<0.05),导管在口腔内盘绕率明显降低〔10.0%(2/20)比55.0%(11/20),P<0.05〕。空肠营养管导丝辅助组与可视喉镜下导丝辅助组、传统手法组置管成功率、牙齿松动和误入气道发生率比较差异均无统计学意义〔第1次置管成功率:70.0%(14/20)比90%(18/20)、40%(8/20),第2次置管成功率:25.0%(5/20)比10.0%(2/20)、15.0%(3/20),牙齿松动发生率:0%(0/20)比10.0%(2/20)、0%(0/20),误入气道发生率:0%(0/20)比0%(0/20)、5.0%(1/20),均P>0.05〕。3组置管过程中均未发生出血现象。结论在气管插管的患者中,为了快速、可靠、成功地插入口胃管,使用导丝和可视喉镜辅助技术均是很好的替代方法。
Objective To compare the differences of the success rates,time,and incidence of adverse events between the two improved techniques of jejunal nutrition tube guide wire and jejunal nutrition tube guide wire under video laryngoscope and traditional techniques.Methods A total of 60 patients,who received tracheal intubation with severe craniocerebral injury combined with skull base fracture or severe craniocerebral injury combined with nasal bone fracture or nasal hemorrhage admitted to the First Hospital of Jiaxing from January 2020 to December 2021 were selected as subjects.Patients were randomized into jejunal nutrition tube guide wire group(with the aid of jejunal nutrition tube guide wire inserted orally gastric tube),jejunal nutrition tube guide wire under video laryngoscope group(with the aid of video laryngoscope and the jejunal nutrition tube guide wire inserted orally gastric tube)and traditional manipulation group(with the aid of traditional methods to insert gastric tube),each group contained 20 patients.The success rates of intubation,catheterization time,and the occurrence of adverse events were observed in the 3 groups.Results Compared with the traditional manipulation group,the success rates of the first intubation in jejunal nutrition tube guide wire under video laryngoscope group was significantly increased[90.0%(18/20)vs.40.0%(8/20),P<0.05],the catheterization time was significantly shortened(seconds:20.85±2.58 vs.35.91±5.07,P<0.05),and the oral coiling rate was significantly decreased[10.0%(2/20)vs.55.0%(11/20),P<0.05].There were no significant differences in the success rate of the first intubation,the second intubation,incidence rate of tooth loosening and stray into the airway between the jejunal nutrition tube guide wire group and the jejunal nutrition tube guide wire under video laryngoscope group and the traditional manipulation group[the success rate of the first intubation:70.0%(14/20)vs.90.0%(18/20),40.0%(8/20),the success rate of the second intubation:25.0%(5/20)vs.10.0%(2/20),15.0%(3/
作者
孙辉
钱敏丽
叶景芬
许俊
郁慧杰
Sun Hui;Qian Minli;Ye Jingfen;Xu Jun;Yu Huijie(Zhejiang Chinese Medical University,Department of Emergency of the First Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2022年第6期727-729,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省嘉兴市医学重点学科建设项目(2019-zc-05)
关键词
留置胃管
气管插管
机械通气
Inserting gastrotube
Tracheal intubation
Mechanical ventilation
