标题：改良式一次性牙垫在气管插管中的应用

      作者：孙国巨 1，王锦秀 2，刘幸福 1，周平明 1，宫雪琦 3，衣瑛 1    (青岛大学附属威海市立第二医院麻醉科 1、普外科 2、审计科 3，山东 威海 264200)

      卷次： 2017年28卷10期

      【摘要】 目的 观察改良式一次性牙垫在气管插管中的应用效果。方法 选取2016年2~10月我院收治的86例气管插管者，按随机数表法将其随机分为观察组和对照组，每组43例。观察组采用改良式一次性牙垫，对照组采用传统牙垫。比较两组患者牙垫应用的效果和安全性。结果 观察组患者气管插管无位移率为88.37%，高于对照组的46.51%，轻度、中度和重度位移率也低于对照组，差异均有统计学意义(P<0.05)；观察组患者的口腔无异味率为88.37%，高于对照组的51.16%，轻度、中度和重度异味率也低于对照组，差异均有统计学意义(P<0.05)；观察组患者的口腔溃疡率和糜烂率分别为4.65%、0，低于对照组的25.58%、4.65%，差异均有统计学意义(P<0.05)；观察组患者的牙垫舒适度为 60.47%，高于对照组的 46.51%，极度不适感为 2.33%，低于对照组的 48.84%，口咽部疼痛评分为(2.48±0.30)分，低于对照组的(4.70±0.35)分，差异均有统计学意义(P<0.05)；观察组患者的口腔护理时间、镇静剂用量和气管插管固定次数分别为(9.05±1.00) min/次、(38.50±10.20) mg/d和(3.00±1.00)次/d，均少于对照组的（15.01±0.68）min/次、(61.00±9.40) mg/d和(5.00±1.00)次/d，差异均有统计学意义(P<0.05)；观察组患者的口腔周围皮肤损伤率、呼吸机相关性肺炎发生率和意外脱管率分别为2.33%、0和0，均低于对照组的9.30%、4.65%、6.98%，差异均有统计学意义(P<0.05)。结论 改良式一次性牙垫是一种实用新型技术，在气管插管中疗效肯定且安全可靠，其有助于提升牙垫应用舒适度、降低意外脱管等并发症发生率、减少临床工作量，值得推广。
      【关键词】 气管插管；改良式一次性牙垫；效果；安全性
      【中图分类号】 R783.2 【文献标识码】 A 【文章编号】 1003—6350（2017）10—1596—04

Application of modified disposable dental pad in endotracheal intubation.
SUN Guo-ju 1, WANG Jin-xiu 2, LIUXing-fu 1, ZHOU Ping-ming1, GONG Xue-qi 3, YI Ying 1. Department of Anesthesiology 1, Department of General Surgery 2,Department of Audit 3, Weihai Municipal Second Hospital Affiliated to Qingdao University, Weihai 264200, Shandong,CHINA
【Abstract】 Objective To observe the effect of modified disposable dental pad in endotracheal intubation.Methods According to the random number table method, 86 cases of tracheal intubation in Weihai Municipal SecondHospital Affiliated to Qingdao University from February 2016 to October 2016 were selected and randomly divided intothe observation group and the control group, with 43 cases in each group. In the observation group, the modified dispos-able dental pad was used, and the traditional dental pad was used in the control group. The effectiveness and safety of thetwo groups of patients were compared. Results In the observation group, the rate of tracheal intubation without dis-placement was 88.37% , which was higher 46.51% in the control group. The mild, moderate and severe displacementrates in the observation group was lower than those in the control group, showing all the differences were statistically sig-nificant (P<0.05). Oral odor did not occur among 88.37% of the patients in the observation group and 51.16% in the con-trol groups, and mild, moderate and severe odors rates in the observation group were lower than those in the controlgroup, showing all the differences were statistically significant (P<0.05). Oral ulceration rate and erosion rate in the obser-vation group was 4.65% and 0, which were lower than 25.58% and 4.65% in the control group, showing the differenceswere statistically significant (P<0.05). The comfort degree of the dental pad in the observation group was 60.47%, whichwas higher than 46.51% in the control group; the extreme discomfort in the observation group was 2.33% , lower than48.84% in the control group; the oropharyngeal pain score (2.48±0.30) was lower than that of the control group (4.70±0.35), showing all the differences were statistically significant (P<0.05). Oral care time, the amount of sedation and thenumber of intubation in the observation group were (9.05±1.00) min/time, (38.50±10.20) mg/d and (3.00±1.00) times/d, re-spectively, which were less than (15.01±0.68) min/time, (61.00±9.40) mg/d and (5.00±1.00) times/d in the control group,showing all the differences were statistically significant (P<0.05 ).The incidence of peritoneal skin injury, the incidence ofventilator-associated pneumonia and the rate of accidental detachment was 2.33%, 0 and 0, respectively, which was lowerthan 9.30%, 4.65% and 6.98% of the control group (P<0.05). Conclusion The improved disposable dental pad is effec-tive and safe in tracheal intubation, which can improve the comfort degree of dental pad, reduce the incidence of compli-cations such as accidental detachment, and reduce the clinical workload. It is a practical new technique, which is worthpromoting.
      【Key words】 Tracheal intub