新型一次性气管插管固定器在无痛胃镜中的临床应用效果

Clinical application of a new disposable tracheal intubation fixator in patients with painless gastroscopy

摘要:

目的 探讨新型一次性气管插管固定器在无痛胃镜中的临床应用效果。方法 根据无痛胃镜中使用的固定器，将患者分为两组，对照组采用传统塑料咬口，观察组采用新型一次性气管插管固定器（胃镜保），两组患者均行无痛胃镜检查。运用倾向评分匹配，消除两组混杂因素后，分析影响不良反应的相关因素。进一步比较两组患者经皮动脉血氧饱和度（SpO₂）、一次性插管成功率、进镜时间、置管稳固性、医护人员吸痰和供氧便捷性情况。结果 1∶1匹配后，对照组和观察组各纳入患者124例，两组患者临床资料比较，差异无统计学意义（P > 0.05），各变量达到均衡，匹配良好。结果表明，观察组躁动、咬口脱出、胃镜咬瘪和咽痛发生率明显低于对照组（P < 0.05）。进一步分析，两组患者检查前SpO₂和心率（HR）比较，差异无统计学意义（P > 0.05）；检查中，对照组HR较检查前明显加快，SpO₂明显降低，差异均有统计学意义（P < 0.05）；观察组变化不明显。观察组插管固定后稳定性和一次性插管成功率明显高于对照组，进镜时间明显短于对照组，差异均有统计学意义（P < 0.05）。另外，观察组吸痰和供氧便捷性更高。单因素和多因素Logistic回归分析表明，年龄 > 70岁、BMI≥24 kg/m²和未采用新型一次性气管插管固定器，是导致无痛胃镜检查中不良反应发生的独立危险因素。结论 无痛胃镜检查中使用新型一次性气管插管固定器，安全性和操作便捷性高，值得临床推广使用。

Abstract:

Objective To study the clinical application of a new disposable tracheal intubation fixator in patients with painless gastroscopy.Methods Patients were divided into two groups according to the fixator used in painless gastroscopy. The control group used traditional plastic bite, and the observation group used a new disposable tracheal intubation fixator (gastroscope protector). Use propensity score matching to eliminate the influence of two groups of potential confounding factors, so that the two groups were comparable, and then analyze the relevant factors affecting adverse reactions. Furthermore, the percutaneous arterial oxygen saturation (SpO₂), the success rate of one-time intubation, the time of entering the lens, the stability of the catheterization, the convenience of sputum suction and oxygen supply of medical staff were compared between the two groups.Results After 1∶1 matching, 124 patients were included in the control group and the observation group. There was no statistically significant difference in general information between the two groups (P > 0.05), indicating that the variables were balanced and well matched. The results showed that the incidence of agitation, bite prolapse, gastroscope bite and sore throat in the observation group was significantly lower than that in the control group (P < 0.05). Further analysis showed that there was no significant difference in SpO₂ and heart rate (HR) between the two groups before examination. During the examination, HR of the control group was significantly faster than that before the examination, and SpO₂ was significantly lower than that before the examination, the differences were statistically significant (P < 0.05). There was no significant change in the observation group. The stability after intubation fixation and the success rate of one-time intubation in the observation group were significantly higher than those in the control group, and the entry time was significantly shorter than that in the control group, with statistically significant differences (P < 0.05). In addition, the convenience of sputum suction and oxygen supply in the observation group was higher. Univariate and multivariate Logistic regression analysis showed that age > 70 years old, BMI ≥ 24 kg/m² and not using the new disposable tracheal intubation fixator were independent risk factors for adverse reactions during painless gastroscopy.Conclusion The new disposable tracheal intubation fixator for painless gastroscopy patients has high safety and convenience of operation, which is worthy of clinical promotion.