中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2014年
35期
41-42
,共2页
经鼻盲探插管术%张口受限%应用
經鼻盲探插管術%張口受限%應用
경비맹탐삽관술%장구수한%응용
Blind nasal intubation%Limitation of mouth opening%Application
目的：研究经鼻盲探插管术在张口受限患者中的应用。方法选择2013年7月—2014年5月收治的口腔科手术患者52例，ASA评分Ⅰ～Ⅱ级。其中32例张口度﹤2 cm，完全张口受限患者20例。导管选择ID 4.0～7.0 mm。麻醉前给予足量抗胆碱药物，必要时给予小剂量咪唑安定和芬太尼静脉注射，在充分表面麻醉下行经鼻盲探插管术，观察在操作过程中血压、心率、脉搏血氧饱和度的变化。结果该组52例患者在充足的麻醉前准备和完善的表面麻醉下经鼻盲探插管全部成功。在插管前与插管后即刻SBP分别为（123.0依9.3)mmHg、（129.0依9.7)mmHg，DBP分别为（72.0依6.2)mmHg、（74.0依6.5)mmHg, HR分别为（82.0依2.4)次/min、（85.3依2.6)次/min，SPO2分别为（99.7依0.5)%、（99.6依0.6)%，盲探插管操作过程的血压、心率、脉搏血氧饱和度无明显变化。术后随访患者无喉痛、声嘶、喉头水肿等并发症。结论经鼻盲探插管在张口受限患者的应用是切实安全、有效地。
目的：研究經鼻盲探插管術在張口受限患者中的應用。方法選擇2013年7月—2014年5月收治的口腔科手術患者52例，ASA評分Ⅰ～Ⅱ級。其中32例張口度﹤2 cm，完全張口受限患者20例。導管選擇ID 4.0～7.0 mm。痳醉前給予足量抗膽堿藥物，必要時給予小劑量咪唑安定和芬太尼靜脈註射，在充分錶麵痳醉下行經鼻盲探插管術，觀察在操作過程中血壓、心率、脈搏血氧飽和度的變化。結果該組52例患者在充足的痳醉前準備和完善的錶麵痳醉下經鼻盲探插管全部成功。在插管前與插管後即刻SBP分彆為（123.0依9.3)mmHg、（129.0依9.7)mmHg，DBP分彆為（72.0依6.2)mmHg、（74.0依6.5)mmHg, HR分彆為（82.0依2.4)次/min、（85.3依2.6)次/min，SPO2分彆為（99.7依0.5)%、（99.6依0.6)%，盲探插管操作過程的血壓、心率、脈搏血氧飽和度無明顯變化。術後隨訪患者無喉痛、聲嘶、喉頭水腫等併髮癥。結論經鼻盲探插管在張口受限患者的應用是切實安全、有效地。
목적：연구경비맹탐삽관술재장구수한환자중적응용。방법선택2013년7월—2014년5월수치적구강과수술환자52례，ASA평분Ⅰ～Ⅱ급。기중32례장구도﹤2 cm，완전장구수한환자20례。도관선택ID 4.0～7.0 mm。마취전급여족량항담감약물，필요시급여소제량미서안정화분태니정맥주사，재충분표면마취하행경비맹탐삽관술，관찰재조작과정중혈압、심솔、맥박혈양포화도적변화。결과해조52례환자재충족적마취전준비화완선적표면마취하경비맹탐삽관전부성공。재삽관전여삽관후즉각SBP분별위（123.0의9.3)mmHg、（129.0의9.7)mmHg，DBP분별위（72.0의6.2)mmHg、（74.0의6.5)mmHg, HR분별위（82.0의2.4)차/min、（85.3의2.6)차/min，SPO2분별위（99.7의0.5)%、（99.6의0.6)%，맹탐삽관조작과정적혈압、심솔、맥박혈양포화도무명현변화。술후수방환자무후통、성시、후두수종등병발증。결론경비맹탐삽관재장구수한환자적응용시절실안전、유효지。
Objective To study the application of blind nasal intubation in patients with limitation of mouth opening. Methods 52 cases with ASA score grade Ⅰ~Ⅱ underwent stomatological operation were selected. Of them, 32 cases had degree of mouth opening < 2cm, and 20 cases had complete limitation of mouth opening. The ID 4.0~7.0mm catheter was selected. Before anesthe-sia, adequate anticholinergic drugs, and when necessary, intravenous injection of small doses of midazolam and fentanyl, were giv-en to the patients, then the patients underwent blind nasotracheal intubation with full surface anesthesia. And the change of blood pressure, heart rate and pulse oxygen saturation during the operation were observed. Results All the 52 patients in this group un-derwent the blind nasal intubation successfully with adequate preanesthetic preparation and perfect surface anesthesia. The SBP of the patients before intubation and immediately after intubation was (123.0±9.3) mmHg, (129.0±9.7) mmHg, respectively, DBP was respectively (72.0±6.2) mmHg, (74.0±6.5) mmHg, HR respectively was (82.0±2.4) times/min, (85.3±2.6) times/min, SPO2 was respectively (99.7±0.5)%, and (99.6±0.6)%, respectively. Blood pressure, heart rate, pulse oxygen saturation in the blind intubation operation process had no obvious change. Postoperative follow-up showed that the patients had no sore throat, hoarseness, laryn-geal edema and other complications. Conclusion Blind nasal intubation is safe and effective for patients with limitation of mouth opening.
