改良胃管插入法在农药中毒昏迷患者中的应用

Feasibility of Stomach and Esophagus Guiding Tube using in Coma Patient with Pesticide Intoxication

目的探讨改良胃管插入法在农药中毒昏迷患者中应用的可行性。方法64例农药中毒昏迷患者，根据胃管插入法的不同被随机分成实验组和对照组，每组32例。对照组采用传统的胃管置入法，实验组采用改良气管导管导引装置插入胃管。观察两组平均置管时间、一次置管成功率及置管过程中的血压及心率变化。结果（1）与插胃管前比较，实验组在插胃管后SBP及HR虽然有增高趋势，但并无显著性（P〉0．05），而对照组病人在插胃管后2min内SBP及HR均显著升高垆〈0．05或P〈0．01）;与对照组比较，实验组HR在插胃管后2min升高的幅度显著降低俨〈0．01）。（2）实验组和对照组平均置管时间分别为（31．2±8．7）s及（86．8±21．6）s，一次置管成功例数分别为32例及20例，与对照组比较，实验组平均置管时间明显缩短（t=3．28，P〈0．01），一次置管成功率显著增加（x2=14．77，P〈0．01）。结论采用改良胃管插入法能够显著减少置管时间及插管过程中的应激反应，提高昏迷患者插胃管成功率。

Objective To investigate the feasibility of stomach and esophagus guiding tube used in coma patients with pesticide intoxication. Methods 64 coma patients with pesticide intoxication were randomly divided into experiment group and control group averagely. Traditional gastric tube insertion were used in control group; and stomach and esophagus guiding tube was used in experiment group. Average insertion time, first insertion achievement ratio, blood pressure（SBP）, and heart ratio （HR） during gastric tube insertion were observed. Rusults （1） Comparing with that before gastric tube insertion, SBP and HR at 2 min after gastric tube insertion in control group increased significantly （P〈0.05 or P〈0.01）. Comparing with that in control group, the change range of HR at 2 min after gastric tube insertion in experiment group decreased markedly （P〈0.01）. （2） Average insertion time were （86.8 ± 21.6）s and （31.2 ± 8.7）s in control group and experiment group, respectively; there was significant difference between both groups 0=3.28, P〈0.01）. First insertion achievement cases were 32 and 20 in experiment group and control group, respectively; there was a significant difference between both groups （X 2= 14.77, P〈0.01）. Conclusion Stomach and esophagus guiding tube can decrease average insertion time and stress reaction of gastric tube insertion and increase first insertion achievement ratio.