CAJ | 학술논문

目的：探讨两种经鼻气管插管固定法预防颌面部手术患者鼻部压疮的效果观察。方法将300例经鼻气管插管全麻手术时间≥4 h患者，随机分为对照组和实验组，每组各150例。对照组采用透明胶布在鼻背固定气管导管，并在导管末端与螺纹管衔接处用厚层纱布包裹；实验组在固定导管前先用美皮康敷贴包裹气管导管弯曲处1圈，然后按对照组方法固定导管。比较手术结束至术后第1天两组患者鼻部压疮发生情况。结果对照组患者鼻部术后Ⅰ期压疮发生率为4.7%，实验组患者未发生压疮，两组患者压疮发生率比较，P＜0.05，差异具有统计学意义，实验组患者压疮发生率明显低于对照组。结论应用美皮康敷贴改进气管导管固定法，能有效预防经鼻气管插管全麻手术≥4h颌面部手术患者鼻部压疮的发生。
목적：탐토량충경비기관삽관고정법예방합면부수술환자비부압창적효과관찰。방법장300례경비기관삽관전마수술시간≥4 h환자，수궤분위대조조화실험조，매조각150례。대조조채용투명효포재비배고정기관도관，병재도관말단여라문관함접처용후층사포포과；실험조재고정도관전선용미피강부첩포과기관도관만곡처1권，연후안대조조방법고정도관。비교수술결속지술후제1천량조환자비부압창발생정황。결과대조조환자비부술후Ⅰ기압창발생솔위4.7%，실험조환자미발생압창，량조환자압창발생솔비교，P＜0.05，차이구유통계학의의，실험조환자압창발생솔명현저우대조조。결론응용미피강부첩개진기관도관고정법，능유효예방경비기관삽관전마수술≥4h합면부수술환자비부압창적발생。
ObjectiveTo discuss two fixation methods of nasotracheal intubation on the occurrence of nasal pressure sores in patients with maxillofacial surgery.MethodsThree hundred cases of patients under general anesthesia more than 4 hours with the nasal endotracheal intubation were randomly assigned into control group and experiment group with 150 cases in each group.In control group,medical tape was used to fix the endotracheal tube to dorsum,wrapping around the joint of endotracheal tube and threaded pipe.In experiment group,Mepilex foam dressing was used to wrap over the bend of endotracheal tube,with gauze covering the joint of endotracheal tube and threaded pipe before fixing the endotracheal tube to dorsum.Finally,the occurrence of pressure sores from the end of surgery to postoperative 1day were compared between the two groups.ResultsThe incidence of patients with first stage pressure sores was 4.7% in control group while none in experiment group.The incidence of nasal pressure sores was much lower in experiment group than that in control group (P<0.05).ConclusionsThe use of Mepilex foam dressing can reduce the pressure and friction between the endotracheal tube and the dorsum,which effectively prevents nasal pressure sores caused by endotracheal intubation.Therefore when having surgery with nasal general anesthesia and nasotracheal intubation and lastsing over 4 hours,the use of application covering the bend of endotracheal tube can prevent nasal pressure sores.