半卧位气管插管的临床应用研究

Clinical application of semi-recumbent-position for endotracheal intubation

目的探讨采取半卧位气管插管对于危重患者的临床应用效果。方法 100例ICU内需行气管插管的患者,随机分为半卧位气管插管组50例和平卧位气管插管组50例,分别采取半卧位或平卧位按常规进行经口气管插管。结果半卧位气管插管组和平卧位气管插管组平均插管准备时间分别为20.0±3.9 s和38.7±7.7 s(P<0.01);喉显露率分别为Ⅰ级9例、Ⅱ级37例、Ⅲ级4例和Ⅰ级15例、Ⅱ级30例、Ⅲ级5例(P>0.05);平均插管时间分别为39.5±10.2 s和41.6±10.6 s(P>0.05);插管成功率均为96.0%(P>0.05);并发症发生率分别为6.0%和12.0%(P>0.05)。结论对于危重患者,采用半卧位气管插管较采用平卧位能减少插管准备时间,并能获得相同的喉显露分级和成功率,尤其适用于紧急气管插管。

Objective To evaluate the effect of semi-recumbent-position for endotracheal intubation in critically ill patients.Methods One hundred ICU patients were randomly divided into semi-recumbent-position endotracheal intubation group（n=50） and horizontal-position endotracheal intubation group（n=50） respectively,and they were prepared to perform routine orotracheal intubation under direct laryngoscopic exposure.Results Their average preparatory time is 20.0±3.9 sec and 38.7±7.7 sec respectively（P0.01）.Their laryngeal exposure in 9 cases is level Ⅰ,37cases of level Ⅱ,4 cases of level Ⅲ in group I,and 15 cases of level I,30 cases of level II,5 cases of level Ⅲ in group II,respectively（P0.05）.The average intubation time is 39.5±10.2 sec and 41.6±10.6 sec,respectively（P0.05）.The successful intubation rate is 96% in both groups（P0.05）.The incidence rates of complications are 6% and 12%,respectively（P0.05）.Conclusion Semi-recumbent-position can reduce the preparatory time for endotracheal intubation and it has similar laryngeal exposure and successful rate,hence it is worthy for clinical application especially in emergency treatment.