CAJ | 학술논문

目的探讨气管插管病人3种不同胃管置入方法的临床效果.方法将 ICU 261例气管插管病人随机分为常规插管组(A组)、导丝导引组(B组)和牵拉气管组(C组)各87例.观察并比较一次插管成功率,置管时间,插管前后心率(HR)、经皮血氧饱和度(SpO2)及插管过程中恶心、呕吐、呛咳及鼻咽黏膜出血等不良反应发生率.结果一次插管成功率比较,B组为83.91%,高于A组的70.11%;C组为98.85%,高于A组、B组,差异均有统计学意义(P＜0.05).置管时间、操作总时间比较,C组较A组、B组缩短(均P＜0.01),B组较A组延长(P＜0.01).置管后HR、SpO2与各自置管前相比,C组无明显变化,A组、B组均明显降低(均P＜0.01).置管过程中恶心、呕吐、呛咳及鼻咽黏膜出血发生率,C组均低于A组、B组(P＜0.05).结论对气管插管病人在镇静状态下牵拉气管的同时置入胃管,准确性高、不良反应少.
목적 탐토기관삽관병인3충불동위관치입방법 적림상효과.방법장 ICU 261례기관삽관병인수궤분위상규삽관조(A조)、도사도인조(B조)화견랍기관조(C조)각87례.관찰병비교일차삽관성공솔,치관시간,삽관전후심솔(HR)、경피혈양포화도(SpO2)급삽관과정중악심、구토、창해급비인점막출혈등불량반응발생솔.결과일차삽관성공솔비교,B조위83.91%,고우A조적70.11%;C조위98.85%,고우A조、B조,차이균유통계학의의(P＜0.05).치관시간、조작총시간비교,C조교A조、B조축단(균P＜0.01),B조교A조연장(P＜0.01).치관후HR、SpO2여각자치관전상비,C조무명현변화,A조、B조균명현강저(균P＜0.01).치관과정중악심、구토、창해급비인점막출혈발생솔,C조균저우A조、B조(P＜0.05).결론 대기관삽관병인재진정상태하견랍기관적동시치입위관,준학성고、불량반응소.
Objective To compare the clinical effect of three kinds of gastric canal inserted method on patients with endotracheal intubation.Methods Two hundred and sixty-one cases of patients with endotracheal intubation were divided into group A(conventional group),B(inserting gastrotuhe by a guide-wire in it),C (pulling the tracheal under calm state),with each group of eighty-seven cases.The intubation successful rate,the time of gastric canal insertion,HR and SpO2 before and after inttthation,and the choking and blcoding occurrence during intubation were observed and compared.Results The intubation successful rate showed significantly higher in the group B(83.91%)than in the group A(70.11%,P＜0.05),and significantly higher in the group C(98.85%)than in the groups A and B(all P ＜ 0.01).In the time of gastrotuhe insertion,significantly quicker in the group B(43.25±5.56s)than in the group A(55.30±6.20)s(P ＜0.01),and significantly quicker in the group C(27.75±4.16)s than in the groups A and B(all P ＜ 0.01);In the total time of whole operation,significantly quicker in the group C(103.16±5.36)s than in the groups A and B(111.45±5.85 s、115.35± 5.25 s,all P ＜0.01),and significantly slower in the group B than in the group A(P ＜0.01).Before and after gastrotube insertion,there was no significant difference on HR in groups B and C(all P＞0.05),in the group A HR was obviously increased(P ＜0.05);while SpO2 there was no significant difference in group C,and the remarkably decreased in groups A and B(P ＜ 0.01,P ＜ 0.05).During the gastrotube insertion,The choking and blcoding occurrence in the group C(2.30%、O)was significantly lower than in the groups A(13.79%、9.20%)and B(8.05%,5.75%)(P＜0.01,P ＜ 0.05),and there was no significant difference in groups B and A(all P ＞0.05).Conclusions It shows higher accurate and less side effect for the endotracbeal intubation patients undergoing gastrotuhe insertion by pulling the tracheal under calm state.