注药式气管导管在术后ICU病人机械通气中的应用

Usage of endotracheal tube for injecting drugs to respiratory mucosa for sedation in postoperative ICU patients

目的采用注药式气管导管对术后机械通气的ICU病人行气道表面麻醉,观察机械通气过程中病人对气管导管的耐受情况。方法选择34例胸腹部手术、术后行机械通气12 h以上的病人,随机分为两组,每组17例。对照组(C组):经注药式气管导管气管内注射生理盐水;治疗组(T组):经注药式气管导管气管内注射2%利多卡因。观察病人在机械通气12 h内气管导管的耐受情况和镇静药物咪唑安定、芬太尼的给药次数及使用量的变化。结果治疗组病人在机械通气12 h内呛咳反应、高血压和心动过速的发生次数显著低于对照组(P<0.05);治疗组病人在机械通气12 h内咪唑安定和芬太尼给药次数和使用量显著低于对照组(P<0.05)。结论使用注药式气管导管进行气道表面麻醉可以显著减轻气管导管引起的不适反应,减少ICU病人的镇静药物用量。

Objective To investigate the effects of endotracheal tube for injecting drugs to respiratory mucosa on sedation effect in postoperative ICU patients,undergoing mechanical ventilation. Methods 34 patients scheduled for thorax and abdomen surgery who required assisted mechanical ventilation over 12 hours after operation. Patients were randomly divided to two groups. In group C,patients were received intermittent midazolamand fentanyl, saline were injected through endotracheal tube for injecting drugs to respiratory mucosa;in group T, patients were received the same sedative and analgesic drugs as in group C, then 2% lidocaine were injected through endotracheal tube for injecting drugs to respiratory mucosa. In both groups, the side effects, sedative and analgesic requirements were recorded during 12 hours ventilation. Results The incidence of tachycardia, hypertension and bucking in group T decreased significantly compared with group C{ P 〈0. 05） ;the requirements of sedative and analgesic drugs decreased significantly compared with group C （ P 〈 0. 05 ）. Conclusion For postoperative ICU patients undergoing mechanical ventilation, using endotracheal tube for injecting drugs can reduced the side effects and requirements of sedative and analgesic drugs.