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投稿时间：2021-04-02 网络发布日期：2021-11-20
投稿时间：2021-04-02 网络发布日期：2021-11-20
中文摘要: 目的 观察经鼻气管插管过程中鼻尖上提法对气管导管通过下部通路的影响，同时分析鼻出血与导管进入的鼻腔通路之间的关系。方法 选择2019年1月至2020年12月南京江北医院行择期耳鼻喉科手术的患者130例，接受经鼻气管插管全身麻醉。随机分为鼻尖上提组（将气管导管插入鼻孔的同时提拉鼻尖）和对照组（在鼻子处于中立位下将导管插入鼻孔），各65例。观察并确定导管经过鼻腔的通路、鼻出血情况、导管通过鼻腔时间以及总的插管时间。结果 鼻尖上提组气管导管进入下部通路的发生率显著高于对照组（76.92% vs 47.69%,χ2=11.824，P<0.01）。两组鼻出血发生率、鼻出血严重程度、导管通过鼻腔时间、气管插管总时间比较差异无统计学意义（P>0.05）。Logistic回归分析显示,鼻出血发生率与导管进入的鼻腔通路显著相关(OR=0.285,95%CI=0.135～0.604，P<0.01)。结论 经鼻气管插管时，鼻出血发生率与导管进入的鼻腔通路显著相关。鼻尖上提法有助于将气管导管引导至下部通路，可能减少鼻出血的发生。
Abstract:Objective During the nasotracheal intubation, the influence of the nose tip lifting method on the tracheal tube passing through the lower passage was observed, and the relationship between epistaxis and the passage of the tracheal tube through the nasal cavity was analyzed. Methods From January 2019 to December 2020, 130 patients underwent elective ear-nose-throat （ENT） surgery were selected for general anesthesia through nasal endotracheal intubation. All the patients were randomly divided into 2 groups: nose tip lifting group (T group, lift the tip of the nose while inserting the tracheal tube into the nostril) and control group (C group, insert the tracheal tube into the nostril with the nose in a neutral position), each with 65 cases. The passage of the tracheal tube through the nasal cavity, the incidence of epistaxis, time of catheter passing through nasal cavity, and the total intubation time were recorded.Results The incidence of tracheal tube passing through the lower passage in T group was significantly higher than that in C group (76.92% vs 47.69%, χ2=11.824, P<0.01). There was no significant difference in the incidence of epistaxis, the severity of epistaxis, time of catheter passing through nasal cavity, and the total intubation time between two groups (P>0.05). Logistic regression analysis showed that the incidence of epistaxis was significantly related to the nasal passage of the tracheal tube (OR=0.285,95%CI=0.135-0.604，P<0.01). Conclusions During nasal endotracheal intubation, the incidence of epistaxis is significantly related to the passage of the tracheal tube through the nasal cavity. Lifting the tip of the nose helps to guide the tracheal tube to the lower passage, which may reduce the occurrence of epistaxis.
文章编号： 中图分类号：R614 文献标志码：B
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附件
| 作者 | 单位 |
| 龚晓毅1 | 1. 南通大学附属南京江北医院麻醉科，江苏 南京 210048； |
| 顾仕贤1 | 1. 南通大学附属南京江北医院麻醉科，江苏 南京 210048； |
| 常胜和1 | 1. 南通大学附属南京江北医院麻醉科，江苏 南京 210048； |
| 朱翔2 | 2. 南通大学附属医院麻醉科，江苏 南通 226001 |
| Author Name | Affiliation |
| ONG Xiao-yi*, GU Shi-xian, CHANG Sheng-he, ZHU Xiang | *Departement of Anesthesiology，Affiliated Nanjing Jiangbei Hospital of Nantong University，Nanjing, Jiangsu 210048, China |
引用文本：
龚晓毅,顾仕贤,常胜和,等.鼻尖上提法对经鼻气管插管时导管进入鼻腔通路的影响[J].中国临床研究,2021,34(11):1524-1527.
龚晓毅,顾仕贤,常胜和,等.鼻尖上提法对经鼻气管插管时导管进入鼻腔通路的影响[J].中国临床研究,2021,34(11):1524-1527.