| 引用本文： |
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黄 永,余 斌,吴 磊,等.新型内镜鼻面罩在纤维支气管镜辅助气管插管中的临床应用[J].同济大学学报（医学版）,2019,40(2):230-234. [点击复制]
- HUANG Yong,YU bin,WU lei,et al.Clinical application of a novel endoscopic nasal mask in fiberoptic bronchoscope-assisted intubation[J].同济大学学报（医学版）,2019,40(2):230-234. [点击复制]
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| 摘要: |
| 目的 探讨新型内镜鼻面罩在纤维支气管镜辅助气管插管中的临床应用。方法 选择60例拟行纤维支气管镜辅助气管插管的患者，随机分为对照组（n=30）和试验组（n=30）: 对照组采用鼻导管供氧右美托咪定联合低剂量丙泊酚静脉麻醉，试验组采用新型内镜鼻面罩供氧右美托咪定联合低剂量丙泊酚静脉麻醉。记录两组患者SPO2＜90%发生率、插管时间及麻醉前（T0）、麻醉后（T1）、纤维支气管镜进入气道即刻（T2）、气管导管送入即刻（T3）、气管插管后5min（T4）各时间点的平均动脉压（mean arterial pressure, MAP）、心率（heart rate, HR），比较患者不良反应发生情况，评估患者麻醉效果评估。结果 两组患者均顺利完成纤维支气管镜辅助气管插管。试验组SPO2＜90%发生率明显低于对照组（P＜0.05）；两组插管时间差异无统计学意义（P＞0.05）。与麻醉前（T0）相比，两组MAP、HR在T1时点降低（P＜0.05）；组间比较，两组MAP、HR在各时点差异无统计学意义（P＞0.05）；两组不良反应发生率差异无统计学意义（P＞0.05）；两组麻醉效果均较好，差异无统计学意义（P＞0.05）。结论 两组方法均能安全有效地用于纤维支气管镜辅助气管插管。新型内镜鼻面罩可有效防止静脉麻醉所引起的舌根后坠，保障呼吸道通畅，且供氧充分便捷，值得在纤维支气管镜辅助气管插管中推广应用。 |
| 关键词: 新型内镜鼻面罩 纤维支气管镜辅助气管插管 鼻导管 右美托咪定 丙泊酚 |
| DOI：10.16118/j.1008-0392.2019.02.018 |
| 投稿时间：2018-10-16 |
| 基金项目:上海市卫生和计划生育委员会科研项目（201640204）；上海科委医学引导类（中、西医）科技项目（1411965600） |
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| Clinical application of a novel endoscopic nasal mask in fiberoptic bronchoscope-assisted intubation |
| HUANG Yong,YU bin,WU lei,LUO Wen-jie |
| (Dept of Anesthesiology, Putuo People’s Hospital, Tongji University, Shanghai 200060, China;Dept. of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| Objective To evaluate the clinical application of a novel endoscopic nasal mask in fiberoptic bronchoscope-assisted intubation. Methods Sixty patients undergoing fiberoptic bronchoscope-assisted intubation during intravenous anesthesia with dexmedetomidine and low dose propofol were randomly assigned to nasal catheter oxygen supply group (control group, n=30) and novel endoscopic nasal mask oxygen supply group (study group, n=30). The primary outcomes including incidence of pulse oxygen saturation (SPO2)＜90%, intubation time; the secondary outcomes including mean arterial pressure (MAP), heart rate (HR) before anesthesia (T0), after anesthesia (T1), immediately after insertion of fiberoptic bronchoscope into the airway (T2), immediately after insertion of tracheal catheter (T3), 5 minute after insertion of tracheal catheter (T4) and the occurrence of adverse reactions and the anesthesia effect were compared between two groups. Results The incidence of pulse oxygen saturation (SPO2)＜90% was significantly lower in study group than that in control group. There was no significant difference in intubation time between the two groups. MAP, HR in both groups decreased at T1 as compared to those at T0. There were no significant differences in the incidence of adverse reactions between two groups. The anesthetic efficacy was favorable in both groups. Conclusion In the intravenous anesthesia with dexmedetomidine and low dose propofol, oxygen supply via nasal catheter or the novel endoscopic nasal mask is safe and effective for fiberoptic bronchoscope-assisted intubation. The novel endoscopic nasal mask can effectively prevent tonguebase falling caused by intravenous anesthesia, protect airway patency to maintain sufficient oxygen supply. |
| Key words: novel endoscopic nasal mask fiberoptic bronchoscope assisted intubation nasal catheter dexmedetomidine propofol |
