气管插管鉴定囊对气管内插管时呼出气体和飞沫的阻断效果

目的 观察一种新研制的气管插管鉴定囊在急诊气管内插管时对患者呼出气体或飞沫的阻断效果.方法 选择急诊抢救中需气管内插管的62例患者进行观察试验,性别不限,年龄21～73岁,所选患者均有不同程度的意识和自主呼吸;按随机数字表法分为两组,每组31例患者.对照组(C组)用普通气管导管;气管插管鉴定囊组(T组)在气管内插管时用接有气管插管鉴定囊的气管导管.观察并记录两组插管过程中有无呛咳发生、操作者面颈部有无感受到在气管导管口处有呼出气流、操作者面颈部有无受到血液或分泌物的沾染.结果 T组全部患者在插管时气管插管鉴定囊均出现了胀缩,但操作者没有感觉到在气管导管口处有呼出气流;插管期间有9例患者发生了呛咳,其中2例使操作者面颈部受到了沾染.C组中有16例插管使操作者感受到在气管导管口处有呼出气流,其中7例出现了呛咳,11例使操作者面颈部受到了沾染.与C组比较,T组的操作者感受到有呼出气流和受到血液、分泌物沾染的发生率低(0比16,2比11,均P＜0.05),插管过程中患者呛咳的发生率差异无统计学意义(9比7,P＞0.05).结论 气管插管鉴定囊用于气管内插管时能够起到阻断呼出气体泄漏或飞沫播散的作用,有助于防控插管时血液或分泌物的喷溅.

Blocking the spray of contaminants from patients' exhalent using a tracheal detecting bulb during endotracheal intubation

Objective To examine the effect of a newly-developed tracheal detecting-bulb (TDB) in preventing the spray of contaminants in patients' exhalent during emergency endotracheal intubation procedure.Methods 62 emergency patients (male or female,age 21 - 73 years,weight 47 - 83 kg,with different levels of consciousness and spontaneous breathing) were randomly divided into two groups (n=31 each) to receive endotracheal intubation by an anesthesiologist with more than 17 years of experience,with (TDB group) or without (control group) a TDB connected to the tracheal tubing.Records were taken regarding the patient's coughing,expansion/contraction of the TDB,the operator's feeling of the patient's exhalent on his face/neck and the contamination of these areas by blood/secrations from the patients in the due course.Results In TDB group,expansion/contraction of TDB occurred in all cases,but the operator felt no exhalent in any of them.In 9 cases the patients coughed but the operator was contaminated only in 2 cases.While in control group,the patients' exhalent was felt in 16 cases.Coughing were recorded in 7 cases,and the operator was contaminated in 11 cases.In comparison with the control group,TDB group had significantly lower (both P＜0.05) incidence in feeling the exhalent (0 vs.16),and contamination by blood or secretions (2 vs.11) although the two groups had no significant difference in the incidence of coughing (9 vs.7,P ＞ 0.05 ).Conclusion TDB can play an important role in blocking the spray of contaminants in patients' exhalent during endotracheal intubation.