摘要
目的对广东省部分二级以上医疗机构气道管理的现状进行调查,为广东省气道管理提供参考。方法采用邮寄调查问卷的方法,对66家医院进行调查。问卷内容包括:麻醉科基本情况,业务开展情况,困难气道相关器械配置情况,常碰到的困难气道情况,常用预测方法,困难气道麻醉,困难气道处理方法等。以三甲、二甲医院为分组变量,采用校正χ2对调查结果进行分析比较。结果手术间与麻醉医师之比为1∶0.99。各医院Macintosh喉镜、口咽通气道、鼻咽通气道和喉罩的配置率为100.0%;纤维支气管镜(纤支镜)12.0%,视频喉镜18.0%,急救环甲膜穿刺套件18.2%。困难气道以肥胖多见(三甲57.5%,二甲53.0%),其次是张口困难(三甲48.1%,二甲44.0%)。困难气道中以喉头暴露困难为多见(三甲47.2%,二甲49.5%)。预测困难气道的主要方法是张口度(三甲53.6%,二甲50.0%)。困难气道时选择清醒气管插管的比例为30.0%(三甲)和17.5%(二甲)。对于环甲膜穿刺或气管切开50.0%(三甲)、30.0%(二甲)的麻醉医师从未做过。结论麻醉科室人力资源依然缺乏,困难气道处理工具配备严重不足,在困难气道处理方面仍需不断改善。
Objective To perform a preliminary survey on management of difficult airway in Guangdong province,in order to provide a reference in improving the airway management in Guangdong province.Methods By mailing questionnaires,anaesthesiologists in 66 hospitals were investigated.Questionnaire contained nine parts which included the general information of anesthesiology department,the area of work,the collocation and usage of various airway devices,difficult airway type and evaluation,anesthesia management of difficult airway.Chi-square analysis was performed for categorical variable（the grade three class-A hospitals or grade two class-A hospital）.Results The ratio of operating room versus anesthetists is 1：0.99.The Macintosh laryngoscope,oral/nasal pharyngeal airway and Laryngeal mask airway were equipped in all the hospitals.However,a few hospitals had advanced airway devices such as fiberoptic scope（12.0%）and video laryngoscope（18.0%）and most of hospitals were short of some emergency airway devices.Among all the type of the diseases in difficult airway,obesity is the most common one（57.5%for three grade and 53.0%for two grade）,followed by restricted mouth opening（48.1%for three grade and 44.0% for two grade）.Mouth opening is the most common used evaluation maneuver（53.6%for three grade and 50.0% for two grade）for the respondents.30.0% anesthetists in grade three hospitals and 17.5%anesthetists in grade two hospitals performed awake intubation for anticipated difficult airway.Nearly half of respondents had never performed cricothyrotomy or thacheotomy.Conclusion Staff shortage is still a big problem.Most of hospitals are lack of advanced tools for difficult airway.Therefore,the management of difficult airway needs to be improved.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第11期1072-1076,共5页
Journal of Clinical Anesthesiology
基金
广东省科学技术厅社会发展项目(2011B031800029)
关键词
气道管理
问卷调查
Airway management
Questionnaire survey
