方素娟 黄祥凌 童志兰 尹晓波广东省中医：手术室，广东广州510120

    神经安定镇痛术在手术室鼻胃管置入中的应用

    方素娟黄祥凌童志兰尹晓波

    广东省中医：手术室，广东广州510120

    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：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)；两组患者胃管置入前后各时点血压、心率和血氧饱和度比较，差异无统计学意义(P>0.05)；N组患者操作一次成功率较C组高(P<0.05)；两组不良反应及患者满意度比较，差异无统计学意义(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。

    神经安定镇痛曰鼻胃管置管曰手术室护理曰结直肠手术

    [Abstract]Objective To investigate the feasibi1ity and safety of neuro1eptana1gesia in nasogastric cannu1ation.Methods Forty patients in surgica1 department of Guangdong Provincica1 Hospita1 of Traditiona1 Chinese Medicine for e1ective 1aparoscopic co1orecta1 surgery during September 2014 to March 2015 were random1y divided into two groups by random number tab1e method,group C and group N,with 20 cases in each group.Nasogastric tubes were inserted in patients of group C after trachea1 intubation,whi1e the nasogastric tubes were inserted into patients of group N,the after injection of neuro1eptana1gesia drugs(inc1uding fentany1 0.1 mg and droporido1 5 mg)2-4 mL before trachea1 intubation.The BP,HR,SpO2,times needed for nasogastric cannu1ation,one time success rates,and satisfaction of patients were recorded when into operating room(T1),before nasogastric cannu1ation(T2),just after nasogastric cannu1ation(T3), 5 min after nasogastric cannu1ation(T4)were recorded;the adverse effects such as vomiting,bucking,injury,sore throat were observed.Results There were no statistica1 differences in genera1 information between two groups(P>0.05). Group C needed more time for nasogastric cannu1ation than group N(P<0.05);there were no significant difference between two groups in BP,HR and SpO2at different time points(P>0.05);one time success rates was significant1y higher in group N than that in the group C(P<0.05);there was no statistica1 difference in the adverse effects and the satisfaction of patients between two groups(P>0.05).Conclusion Neuro1eptana1gesia can shorten the operation time, improve the one time success rate,reducing injury of patients under nasogastric cannu1ation in operating room,it is worthy of c1inica1 app1ication. ......