摘要
目的探讨口咽通气管在全麻术后复苏患者中的应用价值。方法选取2018年1~6月我院胸外科择期全麻术后患者40例,所有患者术后即带气管导管回ICU复苏,将患者随机分成两组,每组20例。A组为试验组,观察患者自主呼吸恢复,存在吞咽及咳嗽反射,自主呼吸试验通过即拔出气管导管,插入口咽通气管至患者意识清醒;B组为对照组,留置气管导管至患者神志完全清醒、自主呼吸及肌力完全恢复后拔出气管导管,比较两组患者气管导管留置时间、通气效果及并发症。结果(1)两组患者气管导管留置时间比较:A组气管导管留置时间为(1.6±0.4)h,B组为(2.9±1.3)h,两组比较有统计学差异;(2)两组患者通气效果比较:两组患者拔管后3h内平均心率、血压、PaO2、PaCO2比较无统计学差异;(3)两组患者并发症比较:A组患者使用口咽通气管期间出现呕吐1例,B组出现躁动导致气管导管移位(脱出1~2cm)致气道黏膜损伤出血者3例,喉头水肿2例、喉痉挛1例。结论全麻术后患者自主呼吸恢复后使用口咽通气管并采取相应的护理措施,可减少气管插管时间,通气安全有效。
Objective To explore the application value of oropharyngeal airway in resuscitation patients after general anesthesia.Methods 40 patients with elective general anesthesia in department of thoracic surgery in our hospital from January 2018 to June 2018 were selected and all patients were returned to ICU with endotracheal catheter for resuscitation after surgery.They were divided into two groups,with 20 cases in each group.Group A was the experimental group.The patients recovered spontaneous breathing,with swallowing and cough reflex.After passing the spontaneous breathing test,the endotracheal tube was pulled out and the oropharyngeal airway was intubated until the patient was conscious.Group B was the control group.The endotracheal tube was indwelled until the patient was fully conscious and the endotracheal tube was removed after spontaneous breathing and complete recovery of muscle strength.The indwelling time of endotracheal catheter,ventilation effect and complications were compared between the two groups.Results(1)Comparison of indwelling time of endotracheal catheter between the two groups:the indwelling time of endotracheal catheter was(1.6±0.4)hours in group A and(2.9±1.3)hours in group B,and there were statistically significant differences between the two groups.(2)Comparison of ventilation effect between the two groups:there was no statistically significant difference in average heart rate,blood pressure,PaO2 and PaCO2 within 3 hours after extubation.(3)Comparison of complications between the two groups:1 patient in group A experienced vomiting during the use of oropharyngeal airway.In group B,there were 3 cases with displacement of endotracheal catheter(with detachment of 1-2cm)resulting in airway mucosal injury and bleeding,2 cases with laryngeal edema and 1 case with laryngospasm.Conclusion After recovering spontaneous breathing of patients with general anesthesia,use of oropharyngeal airway and corresponding nursing measures can reduce the time of tracheal intubation,and ventilation is safe and ef
作者
莫小红
汤红莲
张春燕
廖柳杏
MO Xiaohong;TANG Honglian;ZHANG Chunyan;LIAO Liuxing(First Area of ICU,Gaozhou People’s Hospital,Guangdong,Gaozhou 525200,China)
出处
《中国医药科学》
2019年第20期102-104,241,共4页
China Medicine And Pharmacy
基金
广东省茂名市科技计划项目（2016209）
关键词
口咽通气管
全身麻醉
复苏
气管插管
Oropharyngeal airway
General anesthesia
Resuscitation
Tracheal intubation
