CAJ | 학술논문

目的探讨双腔支气管改造成盲探插管装置配合EtCO2(呼气末二氧化碳)波形监测用于解决颈椎骨折病人困难插管的可行性.方法把颈椎骨折困难插管的病例随机分两组:经口会厌后下方盲探插管组(A组,n=25)和经口双腔支气管改造装置配合EtCO2监测插管组(B组,n=25).分别进行盲探插管并记录统计插管次数、插管时间(从开始插管到听诊证实成功)、插管过程中追加麻药的次数及各时段的血压(BP)、心率(HR)、氧饱和度(SpO2)变化和插管并发症等.结果两组病例插管难度评估无明显差异性(P＞0.05):插管所耗的时间B组为(3.29±1.67)min,明显少于A组的(8.56±4.13)min(P＜0.05): B组1～2次的成功率92%,明显高于A组的32%(P＜0.05).无1例发生低血氧症(SPO2＜92%)、呛咳或气管支气管痉挛等插管并发症.结论双腔支气管改造插管装置配合EtCO2波形图监测用于困难插管,特别对颈椎骨折患者是一种简便、安全、有效的气管插管方法.
목적 탐토쌍강지기관개조성맹탐삽관장치배합EtCO2(호기말이양화탄)파형감측용우해결경추골절병인곤난삽관적가행성.방법 파경추골절곤난삽관적병례수궤분량조:경구회염후하방맹탐삽관조(A조,n=25)화경구쌍강지기관개조장치배합EtCO2감측삽관조(B조,n=25).분별진행맹탐삽관병기록통계삽관차수、삽관시간(종개시삽관도은진증실성공)、삽관과정중추가마약적차수급각시단적혈압(BP)、심솔(HR)、양포화도(SpO2)변화화삽관병발증등.결과 량조병례삽관난도평고무명현차이성(P＞0.05):삽관소모적시간B조위(3.29±1.67)min,명현소우A조적(8.56±4.13)min(P＜0.05): B조1～2차적성공솔92%,명현고우A조적32%(P＜0.05).무1례발생저혈양증(SPO2＜92%)、창해혹기관지기관경련등삽관병발증.결론 쌍강지기관개조삽관장치배합EtCO2파형도감측용우곤난삽관,특별대경추골절환자시일충간편、안전、유효적기관삽관방법.
Objective To investigate the feasibility of solving incubation difficulty in patients with cervical spine fractures using blind tracheal incubation instrument transformed from double-lumen endobron-chial tubes with EtCO2 (end-tidal carbon dioxide) oscillogram monitoring. Methods Patients with cervical spine fractures suffered incubation difficulty were randomly divided into two groups: blind tracheal intubation group (group A, n = 25) and the group of modified double-lumen endobronchial tubes with EtCO2 monitoring (group B, n = 25). Blind tracheal incubation was conducted in the two groups. The number of intubation, intubation duration (from the beginning to successful intubation proved by auscultation), additional uses of anesthetics throughout the intubation period, blood pressure (BP), heart rate (HR), changes of oxygen saturation (SpO2), and intubation complications were recorded, Results There was no significant difference between the two groups in assessment of intubation difficulty (P>0.05), the success rate of incubation for 1 to 2 times was significantly higher in group B than in group A (P<O.05), changes of BP and of HR were significantly smaller than in group A (P<0.05). No hypoxemia (SPO2 <92%), bucking, bronchial spasm, and other complications occurred. Conclusions Modified double-lumen ndobronchial tubes with EtCO2 oscillogram monitoring for patients with intubation difficulty, especially for those with cervical fractures, is a simple, safe, and effective procedure of endotracheal intubation, and is worth popularizing.