CAJ | 학술논문

目的：探究困难气道患者采取盲探插管时应用舒芬太尼及右美托咪定麻醉的临床效果。方法选取在唐山工人医院治疗且伴有气道困难患者，根据术前镇静药物不同将患者分为治疗组及对照组，每组44例。治疗组患者采用右美托咪定进行麻醉处理，对照组采用舒芬太尼进行麻醉处理，后行盲探气管插管术。分别于麻醉前、麻醉诱导完成后、插管到达悬雍垂时、插管到达会厌时、插管完成时及插管完成后5min检测患者的心率、动脉收缩压、动脉舒张压及呼吸频率，以及患者在插管过程中出现恶心、躁动、呛咳及呼吸抑制的例数。结果从麻醉诱导后直至插管完成后5min治疗组患者的呼吸频率高于对照组（P＜0．05）；自导管到达患者悬雍垂时直至插管完成时治疗组患者的动脉收缩压、动脉舒张压及心率明显低于对照组（P＜0．05）；治疗组插管后5min动脉血氧分压为（98．52±9．18）mmHg，明显高于对照组插管后5min动脉血氧分压[（93．46±10．81）mmHg]（P＜0．05）；治疗组患者插管过程中出现恶心、躁动、呛咳、呼吸抑制例数明显低于对照组（P＜0．05），治疗组患者平均插管时间明显低于对照组（P＜0．05）。结论右美托咪定可有效改善困难气道患者的气道状况，达到有效的麻醉效果，降低患者心肺反应性，保证了困难气道患者插管过程的顺利进行。
목적：탐구곤난기도환자채취맹탐삽관시응용서분태니급우미탁미정마취적림상효과。방법선취재당산공인의원치료차반유기도곤난환자，근거술전진정약물불동장환자분위치료조급대조조，매조44례。치료조환자채용우미탁미정진행마취처리，대조조채용서분태니진행마취처리，후행맹탐기관삽관술。분별우마취전、마취유도완성후、삽관도체현옹수시、삽관도체회염시、삽관완성시급삽관완성후5min검측환자적심솔、동맥수축압、동맥서장압급호흡빈솔，이급환자재삽관과정중출현악심、조동、창해급호흡억제적례수。결과종마취유도후직지삽관완성후5min치료조환자적호흡빈솔고우대조조（P＜0．05）；자도관도체환자현옹수시직지삽관완성시치료조환자적동맥수축압、동맥서장압급심솔명현저우대조조（P＜0．05）；치료조삽관후5min동맥혈양분압위（98．52±9．18）mmHg，명현고우대조조삽관후5min동맥혈양분압[（93．46±10．81）mmHg]（P＜0．05）；치료조환자삽관과정중출현악심、조동、창해、호흡억제례수명현저우대조조（P＜0．05），치료조환자평균삽관시간명현저우대조조（P＜0．05）。결론우미탁미정가유효개선곤난기도환자적기도상황，체도유효적마취효과，강저환자심폐반응성，보증료곤난기도환자삽관과정적순리진행。
Objective To explore the application effect of sufentanil or dexmedetomidine on blind intubation in 88 patients with difficult airway .Methods Eighty eight cases of patients with difficult airways in our hospital were divided into treatment group and control group depending on different preoperative sedation .There were 44 cases in each group .Patients in the treatment group were treated with dexmedetomidine anesthesia treatment ,and patients in the control group were treated in clinical routine application of sufentanil anesthesia ,both groups were taken blind intubation after anesthesia treatment .The heart rate ,systolic arterial pressure , diastolic arterial pressure and respiratory rate of patients before anesthesia ,after anesthesia ,when the intubation tube reached uvu‐la ,epiglottis ,when the intubation finished and 5 minutes after the intubation were recorded .Cases of nausea ,dysphoria ,bucking and respiratory depression during the intubation were also recorded .Results From the induction of anesthesia to 5 min after intubation , the respiratory rate of the treatment group was higher than the control group (P<0 .05);the systolic blood pressure ,diastolic blood pressure and heart rate of treatment group were significantly lower than the control group since intubation tube arrive uvula until the completion of systolic (P<0 .05);The arterial oxygen pressure was (98 .52 ± 9 .18) mm Hg in the treatment group 5 min after intubation ,which was significantly higher than the control group which was (93 .46 ± 10 .81) mm Hg (P<0 .05);cases of nausea , dysphoria ,bucking and respiratory depression in the treatment group were significantly lower than that of control group(P<0 .05) , and the average intubation time of the treatment group were significantly shorter than that of control group (P<0 .05) .Conclusion Dexmedetomidine could effectively improve the condition of the patients with difficult airways ,achieve effective anesthesia ,reduce cardiovascular reactivity in patients ,and ensure the smooth progress of intubation for the difficult airway patients .