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目的探讨健忘镇痛慢诱导经口气管插管术在重症监护病房(ICU)应用的可行性、安全性及有效性。方法随机选择25例ICU严重呼吸困难清醒病人,年龄22~68岁,采用健忘镇痛慢诱导经口气管插管。观察记录患者的基础值(T0),环甲膜穿刺时(T1)、插管时(T2)和插管后1 min(T3)各时间点的平均动脉压(MAP)、心率(HR)、收缩(SDP)、心率血压双乘积(RPP)、动脉氧分压(SPO2),以及健忘作用与不良反应。结果25例患者中一次插管成功为22例,1例在操作过程中经助手对环状软骨施以压力后二次插入,2例因颈椎活动受限,喉镜暴露困难,经鼻盲探插管成功。术后随访22例无任何插管并发症,2例诉咽喉痛,1例昏迷。全部清醒患者对插管全过程无记忆。插管前后MAP、HR、SDP、RPP、SPO2变化不大,与基础值相比差异无统计学意义(P>0.05)。结论健忘镇痛慢诱导经口明视气管插管术在重症监护病房应用具有安全性,有效性及切实的可行性。
Objective To investigate the feasibility, safety and efficacy of forgetful analgesia for slow induction of orotracheal intubation in intensive care unit (ICU). Methods Twenty-five patients with ICU severe dyspnea were randomly selected, aged 22-68 years. Slow-induced orotracheal intubation was induced by amnesia and analgesia. The mean arterial pressure (MAP), heart rate (HR), heart rate (HR) and heart rate (MAP) were recorded and recorded at baseline (T0), cricothyroidism (T1), intubation (T2) and intrathecal 1 min Systolic (SDP), heart rate blood pressure double product (RPP), arterial oxygen pressure (SPO2), and amnestic effects and adverse reactions. Results Twenty-two patients were successfully intubated in one of the 25 cases. One patient underwent secondary insertion of cricoid cartilage with an assistant during operation. Two patients had limited access to the laryngoscope because of limited cervical activity. success. Twenty-two patients were followed up for no complications of intubation, 2 vomiting sore throat, and 1 coma. All awake patients without memory of the entire process of intubation. Before intubation MAP, HR, SDP, RPP, SPO2 little change, compared with the baseline value was no significant difference (P> 0.05). Conclusion It is safe, effective and practicable to use forgetful analgesia to induce oral clear intubation intubation in intensive care unit.