摘要
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±9.3）mm Hg、（129.0±9.7）mm Hg,DBP分别为（72.0±6.2）mm Hg、（74.0±6.5）mm Hg,HR分别为（82.0±2.4）次/min、（85.3±2.6）次/min,SPO2分别为（99.7±0.5）%、（99.6±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。
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 anesthesia, 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 underwent 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） mm Hg,（129.0±9.7） mm Hg, respectively, DBP was respectively（72.0 ±6.2） mm Hg,（74.0 ±6.5） mm Hg, 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, laryngeal edema and other complications. Conclusion Blind nasal intubation is safe and effective for patients with limitation of mouth opening.
出处
《中外医疗》
2014年第35期41-42,共2页
China & Foreign Medical Treatment
关键词
经鼻盲探插管术
张口受限
应用
Blind nasal intubation
Limitation of mouth opening
Application
作者简介
苏云锋（1976-），女，河南南阳人，学士，主治医师，主要从事临床麻醉专业。
