巢自莲++++++刘学红++++++麦财就

[摘要]目的 观察全身麻醉诱导下可视置胃管在胆囊腹腔镜手术中的应用效果。方法 选择2014年1月～2016年1月本院接诊的90例胆囊腹腔镜手术患者，将其随机分为观察组和对照组，每组45例。比较两组患者置管成功率和置管时间以及置管前后一般指标变化，分析置胃管时不良反应情况。结果 观察组一次置管成功率为95.56%，显著高于对照组的68.89%，差异有统计学意义（P<0.01）。观察组的置管时间短于对照组[（3.40±0.38）min vs （4.26±0.58）min]，差异有统计学意义（P<0.01）。置管前后，观察组的HR、SPO2、MAP指标比较，差异无统计学意义（P>0.05）。置管后，对照组的HR、MAP与置管前相比明显升高，且高于观察组置管后，差异有统计学意义（P<0.05）。对照组总不良反应发生率为17.78%，观察组患者未出现置管不良反应，两组不良反应发生率比较，差异有统计学意义（P<0.05）。结论 全身麻醉诱导下可视置胃管在胆囊腹腔镜手术中的应用效果显著，可提高一次性置管成功率，缩短置管时间，减轻患者痛苦，降低不良反应发生率，值得在临床推广应用。

[关键词]胃管；全身麻醉诱导；胆囊；腹腔镜手术

[中图分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0020-03

[Abstract]Objective To investigate the application effect of visual nasogastric tube under the general anesthesia induction in the gallbladder laparoscopic surgery.Methods 90 cases of laparoscopic cholecystectomy patients admitted to our hospital from January 2014 to January 2016 were randomly divided into observation group and control group，each group had 45 cases.The success rate and the spending-time of catheterization as well as the general index changes of before and after tube-setting between two groups were compared.The adverse reaction of the nasogastric tube setting was analyzed.Results The success rate of the observation group was 95.56%，which was significantly higher than that of the control group （68.89%），and the difference was statistically significant （P<0.01）.The duration of the observation group was shorter than that of the control group[（3.40±0.38）min vs （4.26±0.58）min]，the difference was statistically significant （P<0.01）.Before and after the intubation，the difference of HR，SPO2，MAP indicators in observation group was not statistically significant （P>0.05）.After the intubation，the control group of MAP， HR and before the tube was significantly higher，and higher than that of the observation group after the tube，the difference was statistically significant （P<0.05）.The incidence rate of adverse reaction in the control group was 17.78%，and there was no adverse reaction in the observation group，and the difference was statistically significant between the two groups（P<0.05）.Conclusion The application of visual nasogastric tube under the general anesthesia induction in the gallbladder laparoscopic surgery has a significant effect and can increase the success rate at the fist-time tube-setting，shorten the time of catheter，relieve pain and reduce the incidence of adverse reactions.It is worthy of clinical application.

[Key words]Gastric tube；General anesthesia induction；Cholecystectomy；Laparoscopic surgery

为减轻腹腔镜手术患者胃肠压力及胃肠胀气，临床常规安置胃管。传统的置胃管方法是患者在清醒状态下进手术室之前进行的。清醒插胃管对咽喉部的刺激会给患者造成极大的心理恐惧和身体痛苦，且临床实践结果也显示[1-3]，该方法一次性置管的成功率低。为减轻患者插胃管造成的身体痛苦和提高插胃管的成功率，临床做了大量的有益探索，如咽喉部喷局部麻醉药插胃管等，但效果仍不显著。为减轻插胃管给患者带来的痛苦，提高置管成功率，本院针对胆囊腹腔镜手术患者，实施全身麻醉诱导后，采用喉镜在可视前提下引导胃管置入，现将应用效果报道如下。

1材料与方法

1.1一般资料

选择2014年1月～2016年1月年本院接诊的90例腹腔镜手术患者作为研究对象，ASAⅠ～Ⅱ级，将90例患者随机分为观察组和对照组，每组45例患者。……