53例困难气管插管的处理
困难气管插管；脉搏血氧饱和度；经口明视插管；盲探插管,,困难气管插管；脉搏血氧饱和度；经口明视插管；盲探插管,1资料与方法,2结果,3讨论,参考文献：
摘要：目的： 探讨困难气管插管的处理方式。方法：困难气管插管患者53例分为A组清醒插管35例，B组全麻诱导插管18例，分别比较2组插管方式、插管时间及面罩间断吸氧时脉搏血氧饱和度(SPO2)最大平均值。结果：2组插管方式比较，A组、B组经口明视插管分别占37.1%、33.3%，盲探插管分别占62.9%、66.7%，差异无统计学意义(P>0.05)；A组、B组SPO2最大平均值达100%～95%者分别占65.7%、27.7%，94%~90%者分别占17.1%、22.2%,<90%者分别占17.1%、50%，组间比较差异有统计学意义(P<0.05)；在盲探插管的5种方式中，联合导气管插管和逆行插管平均时间最短，分别是1.6、1.4 min。结论：已预测的困难气管插管首选清醒插管，操作过程中确保患者氧合良好，无缺氧损害为首要原则。喉外部压迫为困难气管插管时首选的最快捷、简单的改善喉显露方法，在危急情况下应使用逆行气管插管。关键词：困难气管插管；脉搏血氧饱和度；经口明视插管；盲探插管
Treatment of difficult tracheal intubation in fiftythree patients
ZHANG Xi， DUAN Ping， CHEN Hong， et al
(Department of Anesthesiology, Fifth Affiliated Hospital, Xinjiang Medical University,
Urumqi 830011, China)
Abstract: Objective: To investigate the style of difficult tracheal intubation. Methods: Fifty three patients were classified two groups: Group A 35 cases in awaken intubation and group B 18 cases in induction of general anesthesial intubation. The style and time of tracheal intubation and maximum mean value of saturation of hemoglobin (SPO2) of interruptal inspired oxygen with face mask ventilation were compared.Results:Compared with the two groups, Oral intubation under direct vision and blind digital intubation in group A (37.1% and 62.9%)were not significantly different from group B (33.3% and 66.7%) (P>0.05). There was statistical significance (P<0.05) in maximum mean value of SpO2 in two groups. 95 percent to 100 percent of SpO2 was 65.7% in group A and 27.7% in groups B. Less than 90 percent of SpO2 was 17.1% in group A and 50% in group B. The time was the shortest in combitube and retrogression tracheal intubation of five blind digital intubation. Conclutions: In patients with prediction of the difficult intubation should choose awaken intubation at first. The first principle is sure to oxygenate well and no hypoxia. External laryngeal manipulation is the fastest and easiest way to make larynx become visible for intubation. The retrogression tracheal intubation shoud be adopted in dangerous state. ......
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