CAJ | 학술논문

目的：探讨盐酸达克罗宁胶浆作为润滑剂在经口气管插管术中的应用效果及安全性。方法采用前瞻性研究方法，选择2010年12月至2013年6月河北省邢台市人民医院急救部接诊的呼吸衰竭（呼衰）行经口气管插管且意识清楚患者144例，按随机数字表法将患者分为试验组和对照组，每组72例。插管前先给予患者咽喉壁利多卡因喷雾麻醉，试验组以1%盐酸达克罗宁胶浆作为润滑剂，对照组以石蜡油作为润滑剂，两组均以气管插管操作规程进行气管插管术。观察气管插管前后两组患者的心率、收缩压、舒张压、脉搏血氧饱和度（SpO2）、一次置管成功率、呛咳发生率、置管时间的改变及不良反应发生情况。结果两组置管后心率、血压均较置管前明显升高，SpO2较置管前明显降低，以对照组的变化更显著〔心率（次/min）：135.2±9.9比98.1±8.1，收缩压（mmHg，1 mmHg＝0.133 kPa）：145.6±20.8比138.8±22.1，舒张压（mmHg）：96.1±17.6比82.9±22.8，SpO2：0.643±0.128比0.749±0.102，均P＜0.05〕；试验组一次置管成功率明显高于对照组〔98.6%（71例）比84.7%（61例），P＜0.01〕，呛咳发生率明显低于对照组〔36.1%（26例）比52.8%（38例），P＜0.05〕，试验组置管所需时间也较对照组明显缩短（min：1.9±0.9比2.3±1.1，P＜0.05），无药物不良反应发生。结论应用达克罗宁胶浆作为润滑剂行气管插管术，操作简单易行，能有效减少对患者咽喉壁的刺激，提高插管成功率和患者耐受性，无不良反应发生。
목적：탐토염산체극라저효장작위윤활제재경구기관삽관술중적응용효과급안전성。방법채용전첨성연구방법，선택2010년12월지2013년6월하북성형태시인민의원급구부접진적호흡쇠갈（호쇠）행경구기관삽관차의식청초환자144례，안수궤수자표법장환자분위시험조화대조조，매조72례。삽관전선급여환자인후벽리다잡인분무마취，시험조이1%염산체극라저효장작위윤활제，대조조이석사유작위윤활제，량조균이기관삽관조작규정진행기관삽관술。관찰기관삽관전후량조환자적심솔、수축압、서장압、맥박혈양포화도（SpO2）、일차치관성공솔、창해발생솔、치관시간적개변급불량반응발생정황。결과량조치관후심솔、혈압균교치관전명현승고，SpO2교치관전명현강저，이대조조적변화경현저〔심솔（차/min）：135.2±9.9비98.1±8.1，수축압（mmHg，1 mmHg＝0.133 kPa）：145.6±20.8비138.8±22.1，서장압（mmHg）：96.1±17.6비82.9±22.8，SpO2：0.643±0.128비0.749±0.102，균P＜0.05〕；시험조일차치관성공솔명현고우대조조〔98.6%（71례）비84.7%（61례），P＜0.01〕，창해발생솔명현저우대조조〔36.1%（26례）비52.8%（38례），P＜0.05〕，시험조치관소수시간야교대조조명현축단（min：1.9±0.9비2.3±1.1，P＜0.05），무약물불량반응발생。결론응용체극라저효장작위윤활제행기관삽관술，조작간단역행，능유효감소대환자인후벽적자격，제고삽관성공솔화환자내수성，무불량반응발생。
Objective To explore the efficacy and safety of dyclonine hydrochloride mucilage applied as a lubricant for orotracheal intubation. Methods A prospective study was conducted,144 patients with respiratory failure(RF)and clear consciousness admitted into Emergency Department of Xingtai People's Hospital in December 2010 to June 2013 for orotracheal intubation were randomly divided into experimental and control groups(each, 72 cases). Topical spray anesthesia onto the throat wall was applied for all the patients before orotracheal intubation. In the experimental group,the patients received 1%hydrochloric acid dyclonine mucilage as a lubricant,while in the control group,they received paraffin oil as a lubricant before the insertion of tracheal tube. The operating procedure of the insertion was in accord to the rules of orotracheal intubation in both groups. The changes of heart rate,systolic blood pressure,diastolic blood pressure,pulse oxygen saturation(SpO2),success rate of once tracheal intubation,incidence of choking cough,the time of tracheal intubation and dyclonine adverse reactions were observed. Results The heart rate,systolic and diastolic blood pressures were significantly higher and SpO2 was obviously lower after the intubation in both groups than those before the procedure,and the changes were more significant in the control group〔heart rate(bpm):135.2±9.9 vs. 98.1±8.1,systolic blood pressure(mmHg,1 mmHg=0.133 kPa):145.6±20.8 vs. 138.8±22.1,diastolic blood pressure(mmHg):96.1±17.6 vs. 82.9±22.8,SpO2:0.643±0.128 vs. 0.749±0.102, all P<0.05〕;the success rate of once tracheal intubation in experimental group was significantly higher than that in the control group〔98.6%(71 cases)vs. 84.7%(61 cases),P<0.01〕,the incidence of choking cough was obviously lower than that in the control group〔36.1%(26 cases)vs. 52.8%(38 cases),P<0.05〕,the time for insertion of tracheal tube in experimental group was also significantly shorter than that of control group(minutes:1.9±0.9 vs. 2.3±1.1,P<0.05). No drug adverse reactions occurred. Conclusion Compared with paraffin oil,dyclonine hydrochloride mucilage as a lubricant for tracheal intubation is a simpler and easier operation which has the advantages of having better anesthesia,effectively reducing the irritation of the throat wall,improving the success rate of intubation,being more tolerable by the patients,reducing the adverse reaction rate during insertion of tube and having no occurrence of drug adverse reactions,therefore dyclonine can be applied in tracheal intubation.