| 王雄,刘伟.达克罗宁胶浆在困难气道纤维支气管镜引导下经鼻清醒气管插管中的应用[J].安徽医药,2018,22(5):968-970. |
| 达克罗宁胶浆在困难气道纤维支气管镜引导下经鼻清醒气管插管中的应用 |
| Application of dyclonine mucilage in awake bronchofiberscopy intubation |
| 投稿时间：2016-06-15 |
| DOI： |
| 中文关键词: 达克罗宁胶浆 气管导管 清醒插管 纤维支气管镜 |
| 英文关键词: dyclonine mucilage endotracheal tube awake intubation bronchofiberscopy |
| 基金项目: |
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| 摘要点击次数: 2055 |
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| 中文摘要: |
| 目的 探讨达克罗宁胶浆润滑气管导管对困难气道纤维支气管镜(简称纤支镜)引导下清醒气管插管中血流动力学、呛咳反应的影响。方法 选择困难气道纤支镜引导下经鼻清醒气管插管患者116例,采用随机数字表法分为气管导管润滑达克罗宁胶浆润滑组 (R组)与气管导管润滑石蜡油润滑组(S组),每组58例。R组以盐酸达克罗宁胶浆作为润滑剂；S组以石蜡油作为润滑剂；两组以清醒气管插管操作规程进行气管插管,用相同方法维持麻醉。观察并记录气管插管时、插管后两组患者的平均动脉压、心率和脉搏血氧饱和度变化情况；呛咳及躁动发生率；拔管前、拔管时、拔管后5 min、平均动脉压和心率的变化情况。结果 麻醉插管操作时,R组收缩压(100±8.5) mmHg、舒张压(65±5.7) mmHg、心率(85±9)次/分钟的变化明显低于S组[(135±11.5)、(75±6.4) mmHg、(110±11)次/分钟],脉搏血氧饱和度在R组97%±3%明显高于S组90%±4%,组间比较差异有统计学意义(P＜0.05)；插管操作后,两组收缩压、舒张压差异有统计学意义(P＜0.05),两组心率和脉搏血氧饱和度差异无统计学意义(P＞0.05)。R组插管操作呛咳5.4%、躁动发生率8.6%明显低于S组(17.2%、24.1%),差异有统计学意义(P＜0.05)。两组平均动脉压和心率变化随着拔管时间的变化有所不同,R组倾向于低于S组(P＜0.05)。结论 达克罗宁胶浆润滑气管导管插管法减少对患者咽喉壁的刺激,抑制气管插管反应,有效维持血流力学的稳定。 |
| 英文摘要: |
| Objective To investigate the effects of Dyclonine mucilage on hemodynamics and choking cough response during awake bronchofiberscopy incubation.Methods One hundred and sixteen patients with conscious tracheal intubation into difficult airway under the guidance of bronchofiberscope were selected.They were randomly and equally assigned into two goups:endotracheal tube lubrication using Dyclonine hydrochloride mucilage (group R) and endotracheal tube lubrication by paraffin oil (group S).In both groups,tracheal intubation was performed according to the operating procedure of conscious endotracheal intubation,and the anesthesia was maintained with the same method.The changes in mean arterial pressure,heart rate and pulse oxygen saturation were observed in patients during and after tracheal intubation.Choking cough and agitation rates were observed;the changes in mean arterial pressure and heart rate before,during and 5 min after extubation were observed and recorded.Results The changes of systolic blood pressure [(100±8.5) mmHg],diastolic blood pressure [(65±5.7) mmHg],and heart rate [(85±9) beats/min] in group Rwere significantly lower thanthat in group Sduring tubation operation [(135±11.5) mmHg,(75±6.4) mmHg,(110±11) beats/min] (P<0.05),and the pulse oxygen saturation (97%±3%) was significantly higher in Rgroup than that in Sgroup (90%±4%),and there were statistically significant difference between the two groups (P<0.05).After intubation operation,systolic pressure and diastolic pressure have significant differences between the two groups (P<0.05),and there was no statistically significant difference in heart rate and pulse oxygen saturation between the two groups (P>0.05).The incidence of choking cough and agitation in Rgroup (5.4%,8.6%) were significantly lower than that in group S (17.2%,24.1%),and the difference was statistically significant (P<0.05).The changes of the average arterial pressure and heart rate of the two groups were different,along with the change of extubation time,and the average arterial pressure and heart rate in Rgroup lower than that in Sgroup (P<0.05).Conclusions Endotracheal tube lubrication using Dyclonine mucilage reduced throat wall stimulation,inhibited tracheal intubation response,and effectively maintained the stability of hemodynamics. |
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