标题：口腔颌面部全麻手术患者安置胃管时机的探讨

      作者：李静言 1，付光新 1，胡运桃 2，陈 群 1
    (1.泸州医学院附属口腔医院口腔颌面外科，四川 泸州 646000；
2.泸州医学院附属医院手术室，四川 泸州 646000)

      卷次： 2014年25卷2期

      【摘要】 目的 探讨口腔颌面部插管全麻手术需鼻饲流质的患者安置胃管的最佳时机。方法 随机选取2011
年9月至2012年6月我科口腔颌面部手术后需安置胃管的患者60例作为对照组，2012年7月至2013年4月我科口
腔颌面部手术后需安置胃管的患者60例作为观察组。观察组于手术结束后、麻醉拔管前在麻醉师的协助下利用可
视喉镜安放胃管，对照组于术后第一天患者清醒状态下在病房安置胃管。比较两组患者安置胃管的一次性成功率，
安置胃管失败例数，安置胃管前和安置胃管时心率、血压变化，拒绝安置胃管的例数，术后患者对安置胃管时机的选
择。结果 观察组一次性插管成功率明显高于对照组(P<0.01)；观察组安置胃管失败人数明显低于对照组(P<0.01)；
与基础值比较，观察组在安置胃管时血压、心率无明显变化，而对照组明显增高(P<0.001)；对照组拒绝安置胃管的人
数明显高于观察组；留管期间调查，患者要求手术结束后、麻醉拔管前安置胃管率为100%。结论 口腔颌面部插管
全麻手术需鼻饲流质的患者安置胃管的最佳时机是手术结束后、麻醉拔管前。

      【关键词】 全麻；口腔颌面部；胃管；时机

      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2014）02—0309—03


Timing of putting stomach tube of general anesthesia patients in oral and maxillofacial region.
LI Jing-yan 1, FU
Guang-xin 1, HU Yun-tao 2, CHEN Qun 1. 1. Stomatology Hospital of Luzhou Medical College, Luzhou 646000, Sichuan,
CHINA; 2. Operating Room, the Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan, CHINA

【Abstract】 Objective To explore the best moment of putting stomach tube when the patient with general an-
esthesia was performed operation in oral and maxillofacial region. Methods Sixty patients who needed to put stom-
ach tube after operation in oral and maxillofacial department from September, 2011 to June, 2012 were selected as con-
trol group randomly, with 60 patients from July, 2012 to April, 2013 as experimental group. The patient of experimen-
tal group was put stomach tube at the time when the operation was over and before trachea, and cannula was extracted
through visionlaryngoscope with the help of anesthetist and the patient of control group at the first day after operation
in ward. The rate of success of putting stomach tube of the first time, number of failure, change of heart rate and blood
pressure before and when putting stomach tube, number of refusing to put stomach tube and the time of the patient
chosing to put stomach tube were compared between the two groups. Results The rate of success of putting stomach
tube of the first time of experimental group was significantly higher than that in control group (P<0.01). The number
of failure of experimental group was significantly lower than that in control group (P<0.01). Compared with the basis,
the heart rate and blood pressure of experimental group had no significant change and those of control group rised ob-
viously (P<0.001). The number of refusing to put stomach tube in control group was significantly higher than that in
experimental group. 100% patients required stomach tube to be put at the time after operation and before trachea can-
nula was extracted. Conclusion The best timing of putting stomach tube in oral and maxillofacial operation under
general anesthesia is the time after operation or before trachea cannula is extracted.