住培医生实施纤支镜引导经鼻气管内插管的影响因素分析

Analysis of the Success Rate and Influencing Factors of the Fiberoptic Nasotracheal Intubation Performed by Training Residents

目的观察麻醉科轮训医生在实施纤支镜引导下经鼻腔气管内插管成功率的影响因素。方法选择住培医师120人,经过不少于60分钟的集中培训后分别对120例患者进行纤支镜引导下鼻腔气管内插管,评估其气管内插管的成功率及影响因素。结果在纤支镜引导下鼻腔气管内插管中,住培医生的一次成功率为26.2%,两次成功率为60.2%,失败率为39.8%。Logistic因素分析结果显示曾经使用过纤维支气管镜、博士学历、患者接受全身麻醉是住培医生实施纤支镜引导下经鼻腔气管内插管成功的有利因素。结论背景知识的熟练掌握与技能培训相结合仍是提高是住培医生气道管理技能的重要手段。

Objective To investigate the success rate and influencing factors of fiberoptic nasotracheal intubation （FNI） performed by training residents in the department of anesthesiology. Methods A total of 120 resident doctors were selected and after 60 minutes of intensive training, 120 cases of patients were subjected to endotracheal intubation under the guidance of fberoptic bronchoscope to evaluate the success rate and infuencing factors of endotracheal intubation. Results The success rate of FNI was 26.7% for the frst attempt, 60.2% for the second attempt and the total failure rate of FNI was 39.8%. Logistic multivariate analysis showed that experience of FNI, degree of phD and general anesthesia were propitious to success rate of FNI. Conclusion The combination of profciency in background knowledge and training is still an important means to improve the skills of airway management in residents.