神经安定镇痛术在手术室鼻胃管置入中的应用.docVIP

神经安定镇痛术在手术室鼻胃管置入中的应用 　　[摘要] 目的 探讨神经安定镇痛术用于手术室鼻胃管置入的可行性和安全性。 方法 选取2014年9月～2015年3月广东省中医院外科择期行腹腔镜下结直肠手术患者40例为研究对象，按随机数字表法分为对照组（C组）和神经安定镇痛组（N组），每组20例。C组患者气管插管后将鼻胃管从鼻腔缓缓插入所需深度。N组患者静脉注射神经安定镇痛合剂（芬太尼0.1 mg，氟哌利多5 mg）2～4 mL后将鼻胃管先放入鼻后孔处，嘱患者做吞咽动作，随吞咽活动将胃管插入所需深度，之后常规诱导气管插管。记录患者一般情况及入室时（T1）、操作前（T2）、操作后即刻（T3）、操作后5 min（T4）的患者的血压、心率、血氧饱和度、置管操作时间、操作一次成功率及患者对操作的满意度；观察操作过程中呕吐、呛咳、操作损伤（置管过程有黏膜破损出血）、咽痛等不良反应的发生率。 结果 两组患者术前一般情况比较，差异无统计学意义（P 0.05）；N组操作时间较C组短（P 0.05）；N组患者操作一次成功率较C组高（P 0.05）。 结论 神经安定镇痛术用于患者术前鼻胃管置入可缩短操作时间，提高一次成功率，减轻患者损伤，值得临床推广应用。 　　[关键词] 神经安定镇痛；鼻胃管置管；手术室护理；结直肠手术 　　[中图分类号] R472.91 [文献标识码] A [文章编号] 1673-7210（2016）04（a）-0163-04 　　[Abstract] Objective To investigate the feasibility and safety of neuroleptanalgesia in nasogastric cannulation. Methods Forty patients in surgical department of Guangdong Provincical Hospital of Traditional Chinese Medicine for elective laparoscopic colorectal surgery during September 2014 to March 2015 were randomly divided into two groups by random number table method， group C and group N， with 20 cases in each group. Nasogastric tubes were inserted in patients of group C after tracheal intubation， while the nasogastric tubes were inserted into patients of group N， the after injection of neuroleptanalgesia drugs （including fentanyl 0.1 mg and droporidol 5 mg） 2-4 mL before tracheal intubation. The BP， HR， SpO2， times needed for nasogastric cannulation， one time success rates， and satisfaction of patients were recorded when into operating room （T1）， before nasogastric cannulation （T2）， just after nasogastric cannulation （T3）， 5 min after nasogastric cannulation （T4） were recorded； the adverse effects such as vomiting， bucking， injury， sore throat were observed. Results There were no statistical differences in general information between two groups （P 0.05）. Group C needed more time for nasogastric cannulation than group N （P 0.05）； one time success rates was significantly higher in group N than that in the group C （P 0.05）. Conclusion Neur