【摘要】 目的综合运用各种清醒气管插管技术,对困难气道急诊患者实施救治,前瞻性预测困难气道插管的方法,分析其困难气道与急诊疾病的相关性。方法对200例需急诊气管插管的患者,采用综合评分法,预测困难气道并将其分为4组,对4组患者分别首选不同的气管插管方式,统计插管结果,分析困难气道相关因素。评价不同插管方法的成功率及对患者的影响。结果200例患者中,插管顺利的149例,占74.5%,困难气道患者51例,占25.5%。急诊插管失败4例,占2%。困难气道成因与急诊疾病成正相关;与患者的非合作体位呈正相关;与患者解剖因素成正相关。4种经鼻插管(经鼻盲探、经鼻明视、经鼻软化盲探、经鼻明视+送管钳气管插管)方式,总成功率为82.35%。结论急诊患者困难气道主要与患者的疾病相关,患者多呈昏迷或不合作状态,没有充足的时间进行细致的解剖测量,需要迅速判定困难程度,选择适合的插管方式。经鼻插管是对急诊困难气道患者的首选。更多还原

【Abstract】 Objective To intubate the emergency patient with difficult airway by appling different techniques of tracheal intubation for conscious patient;to predict the proper ways of intubation for patient with difficult airway;to analylize the relationship between difficult airway and disease.Method Using comprehensive assessment method to predict the level of difficult airway for 200 patients who need emergent Endotracheal(ET) tube insertion.Two hundred cases were divided into four groups and applied different techniques of tracheal intubation for each group,then statistics the results to read the relative factors arising difficult airway.To evaluate the effect to patient by using different ways of ET tube insertion.Result There were 149 succeed cases among 200 cases of ET tube intubation,which referred to 74.5%,and 51 cases with difficult airway,which referred to 25.5%,there were 4 cases failed,which referred to 2%.Difficult airway was mainly related to disease and patient’s uncooperative position as well as local anatomy constructure.The total successful rate was 82.35% for four different intubations via nasal(nasaltracheal intubation,blind nasaltracheal,soften ET catheter,nasaltracheal with clippers).Conclusion Difficult airway in emergency patient is mainly related to disease because of most patients were in coma and uncooperative.In such emergent circumstance,there is no much time for delicate anatomy measurements,on the contrary,we need quickly assess the level of difficult airway to choose the proper way of tracheal intubation.更多还原