CAJ | 학술논문

目的：通过临床实验观察咽部放置带套囊气管导管充气后防治舌后坠的效果，推荐一种简单易行的麻醉期间呼吸道管理措施。方法：将40例择期腹盆腔手术患者随机分为对照组和实验组各20例，肌注鲁米那和阿托品，接受硬膜外麻醉及静脉强化麻醉。当患者出现舌后坠的典型症状及SpO2≤94%时，观察组经口置入一ID7.5的带套囊塑料气管导管，套囊充气，当患者苏醒不能耐受时，拔除导管。保留期间导管末端接麻醉机给氧。观察导管置入前后患者SpO2及呼吸状态的变化。对照组中将患者头偏向一侧，用托下颌的方法保持呼吸道通畅并适当减浅麻醉。结果：导管置入后，所有患者SpO2均由置管前的94%回升到98%以上（P<0.05），舌后坠症状明显改善。结论：采用咽后置入带套囊塑料气管导管法，充气后可明显缓解和改善舌后坠引起的呼吸道梗阻和缺氧，导管位置容易确定，咽部刺激轻微，口腔分泌物吸引方便，不影响给氧，操作简单，是值得临床推荐的一种防治舌后坠的有效方法。
목적：통과림상실험관찰인부방치대투낭기관도관충기후방치설후추적효과，추천일충간단역행적마취기간호흡도관리조시。방법：장40례택기복분강수술환자수궤분위대조조화실험조각20례，기주로미나화아탁품，접수경막외마취급정맥강화마취。당환자출현설후추적전형증상급SpO2≤94%시，관찰조경구치입일ID7.5적대투낭소료기관도관，투낭충기，당환자소성불능내수시，발제도관。보류기간도관말단접마취궤급양。관찰도관치입전후환자SpO2급호흡상태적변화。대조조중장환자두편향일측，용탁하합적방법보지호흡도통창병괄당감천마취。결과：도관치입후，소유환자SpO2균유치관전적94%회승도98%이상（P<0.05），설후추증상명현개선。결론：채용인후치입대투낭소료기관도관법，충기후가명현완해화개선설후추인기적호흡도경조화결양，도관위치용역학정，인부자격경미，구강분비물흡인방편，불영향급양，조작간단，시치득림상추천적일충방치설후추적유효방법。
Objective:To observe the effect of prevention and cure of upper respiratory tract obstruction using endotracheal tube with inflated cuff which was put into pharynx,recommend a simple and easy measure to administer respiratory tract which is usually obstructed during anesthesia. Method:Forty patients who were going to scheduled for abdominal or pelvic surgery were randomly average divided into two groups:all the patients received epidual anesthesia and reinforced with midazolam and Dezocine. In experimental group,when typical symptom of upper respiratory tract obstruction appeared and SpO2 was decreased to 94%,a ID7.5 endotracheal tube with cuff was put into pharynx through mouth,charging the cuff and keeping it just behind the lingua,to eliminate the tube when patients can not tolerate. Giving O2 through face mask or tube during anesthesia. To observe the changes of SpO2 and the behavior of respiratory. In control group,patients were maintaining the airway open with the head partial to one side and giving a jaw thrust method, lightening the anesthesia is also been used. Result:SpO2 of the patients in experimental group recovered over 98%from 94%before putting into the tube (P<0.05),the symptom of upper respiratory tract obstruction was obviously relieved.Conclusion:Put an endotracheal tube with cuff into the pharynx, charge the cuff and keep it just behind the lingua can obviously relieve the symptom of upper respiratory tract obstruction and hypoxia. The position of tube was easily determine and the stimulation to pharynx was slightly,stomat-secretion can be conveniently removed and easy to give O2. It suggests to be a effective method of preventing and curing upper respiratory tract obstruction in clinic.