慢诱导插管在急诊困难插管中的应用

摘要

Objective To observe the application effect of surface anaesthesia slow induction in emergency intubation difficulty with endotracheal intubation. Methods 20 cases of severe dyspnea patients were included. The age ranged from 22 to 82 years old. In the use of sedative drugs after conventional after failed intubation using analgesia induction and tracheal intubation through mouth. Observation records of patients with the base value (TO). The cricothyroid membrane puncture (Tl). Intubation (T2) and lmin after intubation (T3) at different time points in mean arterial pressure (MAP), heart rate (HR), systolic pressure (SDP), arterial partial pressure of oxygen (SPO2). And forget the effect and adverse reaction. Results In 20 patients, a successful intubation for 18 cases. In 1 case during operation by the assistant to the cricoid pressure after the two insert. In 1 patient with facial trauma, trismus, blind nasal intubation success. Until the patient conscious, postoperative follow-up in 20 cases without any complications of intubation, 2 cases of V. sore throat, 1 case of coma. Fully awake patients to accept the process without memory. MAP, HR, SDP before intubation, little change. Comparing with baseline differences were not statistically significant (P>0. 05) SPO2 has significantly improved (P<0. 05). Conclusion Analgesia induction and tracheal intubation in the emergency intubation are safe, effective and feasible.%目的 观察咽喉表面麻醉慢诱导气管内插管在急诊困难插管中的应用效果.方法 选择20例严重呼吸困难病人,在使用镇静药物常规插管失败后采用健忘镇痛慢诱导经口气管插管,观察记录患者的基础值(T0),环甲膜穿刺时(T1)、插管时(T2)和插管后1min(T3)各时间点的平均动脉压(MAP)、心率(HR)、收缩压(SDP)、动脉氧分压(SPO2),以及健忘作用与不良反应.结果 20例患者中一次插管成功18例,1例在操作过程中经助手对环状软骨施以压力后二次插入,1例因面部外伤,张口困难,经鼻盲探插管成功.待病人清醒后,随访20例无任何插管并发症,2例诉咽喉痛,1例昏迷.全部清醒患者对插管全过程无记忆.插管前后MAP、HR、SDP变化不大,与基础值相比差异无统计学意义(P＞0.05).SPO2有明显改善(P＜0.05).结论 健忘镇痛慢诱导气管插管术在急诊困难插管中的应用具有安全性、有效性及可行性,可在临床推广应用.