重型破伤风气管切开后胃管置入方法的临床效果比较

Clinic Effect Comparison of Gastric Canal Inserted Methods in the Patients with Severe Tetanus Undergoing Tracheotomy

目的:探讨重型破伤风病人气管切开后2种不同胃管置入方法的临床效果。方法:将我院感染内科重型破伤风气管切开患者174例随机分为常规插管法(对照组)、遇阻力一边注入空气冲击一边插管法(观察组)各87例。观察并比较一次插管成功率,插管前后心率(HR)、经皮血氧饱和度(sPO2)及插管过程中抽搐、恶心、呕吐、呛咳及鼻咽黏膜出血等不良反应发生率。结果:一次插管成功率比较,观察组为98.85%,高于对照组的70.11%,差异有统计学意义(P<0.05)。置管后HR、sPO2与置管前相比,观察组无明显变化,对照组明显降低(P<0.01)。置管过程中抽搐、恶心、呕吐、呛咳及鼻咽黏膜出血发生率,观察组低于对照组(P<0.05)。结论:对重型破伤风气管切开病人在镇静状态下插管过程中遇阻力时一边注入空气冲击一边置入胃管,准确性高、不良反应少。

Objective：To explore two clinical effects of gastric canal insertion in the patients with severe tetanus undergoing tracheotomy.Method：174patients with severe tetanus who received tracheotomy were randomly divided into two groups with 87in each.Control group was treated with conventional method,the observation group was treated with air injection in the blocking of insertion.The intubation successful rate,HR,sPO2,before and after intubation,as well as the incidence of adverse reactions such as the convulsion,nausea,vomiting,nasopharyngeal bleeding and choking were observed and compared.Results：There was remarkable difference between control group（70.11%）and observation group（98.85%,P0.05）.Before and after gastric canal insertion,it showed no obvious difference in HR,sPO2in control group,while these vital signs decreased significantly in observation group（P0.01）.The incidence rate of the convulsion,nausea,vomiting,nasopharyngeal bleeding and choking in observation group was lower than that in the control group（P0.05）.Conclusion：For the patients with severe tetanus undergoing tracheotomy,gastric canal insertion had a higher accuracy and less side effect with air injection in the blocking of insertion.