中国保健营养（上旬刊）
中國保健營養（上旬刊）
중국보건영양（상순간）
China Health Care & Nutrition
2014年
4期
1854-1855
,共2页
喉麻管%环甲膜穿刺%经鼻盲探气管插管%颅脑损伤%急救
喉痳管%環甲膜穿刺%經鼻盲探氣管插管%顱腦損傷%急救
후마관%배갑막천자%경비맹탐기관삽관%로뇌손상%급구
Laryngotracheal topical anesthesia kit%Thyrocricoid puncture%Blind nasotracheal intubation%Acute craniocerebral injury%Emergency treatment
目的：采用2％利多卡因经喉麻管喷雾行鼻腔、咽喉部表麻并联合环甲膜穿刺气管内表麻，探讨在颅脑损伤患者经鼻盲探气管内插管病区急救中的应用效果。方法将60例需经鼻盲探气管插管的急性颅脑损伤患者随机均分为2组：环甲膜穿刺注药组（Ⅰ组）和喉麻管联合环甲膜穿刺注药组（Ⅱ组），行经鼻盲探气管内插管。观察两组患者气管插管过程中平均动脉压（MAP）和心率（HR）的最大值，记录 MAP变化率＞30％、HR 变化率＞30％发生的例数；气管插管操作反应评分；并记录成功气管插管所需的插管次数。结果与Ⅰ组比较，Ⅱ组患者气管插管过程中MAP和HR的最大值及MAP变化率＞30％、HR变化率＞30％发生的例数均低于Ⅰ组（P＜0．05）；气管插管操作反应评分及成功气管插管所需的插管次数比较，Ⅱ组低于Ⅰ组（P＜0．05）；差异有统计学意义。结论2％利多卡因经喉麻管喷雾行鼻腔、咽喉部表麻并联合环甲膜穿刺气管内表麻，能降低颅脑损伤患者经鼻盲探气管内插管的心血管反应，降低气管插管的呛咳反射，提高经鼻盲探插管的成功率，在颅脑损伤患者经鼻盲探气管内插管病区急救中应用，是一种比较完善、有效、安全的表面麻醉方法，具有一定的临床应用价值。
目的：採用2％利多卡因經喉痳管噴霧行鼻腔、嚥喉部錶痳併聯閤環甲膜穿刺氣管內錶痳，探討在顱腦損傷患者經鼻盲探氣管內插管病區急救中的應用效果。方法將60例需經鼻盲探氣管插管的急性顱腦損傷患者隨機均分為2組：環甲膜穿刺註藥組（Ⅰ組）和喉痳管聯閤環甲膜穿刺註藥組（Ⅱ組），行經鼻盲探氣管內插管。觀察兩組患者氣管插管過程中平均動脈壓（MAP）和心率（HR）的最大值，記錄 MAP變化率＞30％、HR 變化率＞30％髮生的例數；氣管插管操作反應評分；併記錄成功氣管插管所需的插管次數。結果與Ⅰ組比較，Ⅱ組患者氣管插管過程中MAP和HR的最大值及MAP變化率＞30％、HR變化率＞30％髮生的例數均低于Ⅰ組（P＜0．05）；氣管插管操作反應評分及成功氣管插管所需的插管次數比較，Ⅱ組低于Ⅰ組（P＜0．05）；差異有統計學意義。結論2％利多卡因經喉痳管噴霧行鼻腔、嚥喉部錶痳併聯閤環甲膜穿刺氣管內錶痳，能降低顱腦損傷患者經鼻盲探氣管內插管的心血管反應，降低氣管插管的嗆咳反射，提高經鼻盲探插管的成功率，在顱腦損傷患者經鼻盲探氣管內插管病區急救中應用，是一種比較完善、有效、安全的錶麵痳醉方法，具有一定的臨床應用價值。
목적：채용2％리다잡인경후마관분무행비강、인후부표마병연합배갑막천자기관내표마，탐토재로뇌손상환자경비맹탐기관내삽관병구급구중적응용효과。방법장60례수경비맹탐기관삽관적급성로뇌손상환자수궤균분위2조：배갑막천자주약조（Ⅰ조）화후마관연합배갑막천자주약조（Ⅱ조），행경비맹탐기관내삽관。관찰량조환자기관삽관과정중평균동맥압（MAP）화심솔（HR）적최대치，기록 MAP변화솔＞30％、HR 변화솔＞30％발생적례수；기관삽관조작반응평분；병기록성공기관삽관소수적삽관차수。결과여Ⅰ조비교，Ⅱ조환자기관삽관과정중MAP화HR적최대치급MAP변화솔＞30％、HR변화솔＞30％발생적례수균저우Ⅰ조（P＜0．05）；기관삽관조작반응평분급성공기관삽관소수적삽관차수비교，Ⅱ조저우Ⅰ조（P＜0．05）；차이유통계학의의。결론2％리다잡인경후마관분무행비강、인후부표마병연합배갑막천자기관내표마，능강저로뇌손상환자경비맹탐기관내삽관적심혈관반응，강저기관삽관적창해반사，제고경비맹탐삽관적성공솔，재로뇌손상환자경비맹탐기관내삽관병구급구중응용，시일충비교완선、유효、안전적표면마취방법，구유일정적림상응용개치。
Objective To investigate the application effect of topical anesthesia with 2%lidocaine through the laryngotracheal topical anesthesia kit and thyrocricoid puncture in emergency treatment on patients with acute craniocerebral injury during blind nasotracheal intubation .Methods Sixty patients with acute craniocerebral injury by blind nasotracheal intubation were randomly divided into 2 groups:thyrocricoid puncture group(Ⅰgroup)and laryngotracheal topical anesthesia kit and thyrocricoid puncture group(Ⅱgroup) .All patients were underwent blind nasotracheal intubation.The highest values of MAP and HR during intubation between the 2 groups were compared,the incidence of changes MAP and HR>30%of baseline values was recorded.The intubation response was scored,and the frequencies of blind nasotracheal intubation were recorded.Results The highest values of MAP and HR during intubation and the incidence of changes MAP and HR >30%of baseline values were signifi-cantly lower in group Ⅱ than in group Ⅰ(P<0.05).The intubation response scores and the frequencies of blind nasotracheal intubation were lower in group Ⅱ than in group Ⅰ(P<0.05).The difference was statistically significant.Conclusion It is a more perfect,effective,and safe topical anesthesia with 2% lidocaine through the la-ryngotracheal topical anesthesia kit and thyrocricoid puncture ,which can effectively reduce the cardiovascular response and the cough reflex to tracheal intubation in pa-tients with craniocerebral injury during the blind nasotracheal intubation ,furthermore which can improve successful rate of the blind nasotracheal intubation.
