经鼻气管插管在烧伤麻醉中的应用探讨

目的研究经鼻气管插管在烧伤麻醉中的应用。方法选取拟在全麻下施行择期烧伤整形手术的成年患者80例分为A组(40例)和B组(40例)。A组经鼻气管插管,B组不插管。两组均保持自主呼吸观察记录心血管反应和呼吸情况。结果 A组插管时平均动脉压(MAP)、心率(HR)升高较明显,插管后有所下降。与术前基础值相比,两组术中MAP、HR均有升高,但两组升高程度无明显差异。A组患者呼吸平稳,SpO2始终维持在98.4%±1.3%,B组患者SpO2维持在92.6%±1.5%,其中3例低于90.0%,1例予面罩吸氧后缓解,另2例行紧急气管切开。结论与传统的基础麻醉相比,经鼻气管插管更能保持呼吸道通畅,有利于呼吸管理,大大提高烧伤麻醉的安全性,具有很好的价值,值得临床推广应用。

Study on clinical efficacy of nasotracheal intubation in burnt anesthesia

Objective To explore the clinical effect of nasotracheal intubation in burnt anesthesia.Methods Select eighty adult patients scheduled for elective burnt or plastic surgery under general anesthesia.They were divided into group A(40 case)and group B(40 case).Group A was treated with nasotracheal intubation.Group B wasn’t treated with intubation.Both of the groups were kept spontaneous breathing.The clinical features such as mean arterial pressure(MAP)、heart rate(HR)and SpO2 were observed and recorded.Results In group A,MAP and HR increased obviously during intubation,but decreased after intubation.Compared with their baseline values,MAP and HR in both groups increased during surgery,but the degree of increasing wasn’t significantly different between two groups.In patients of group A,breathe with smooth,SpO2 always kept 98.4%±1.3%.In patients of group B,SpO2 kept 92.6%±1.5%,but three cases of them below 90.0%,one revived after was treated with oxygen mask,the others were treated with urgent tracheotomy.Conclusion Compared with traditional general anesthesia,nasotracheal intubation can even maintain airway patency,it is good for respiratory management.It increased greatly the safety factor of burnt anesthesia and it is definitely valuable for burnt patient and worthy of being recommend for use in clinical practice.