论文部分内容阅读
目的:采用问卷形式调查我国麻醉医师对新型冠状病毒肺炎(COVID-19)患者实施气管插管术的现状。方法:采用自行设计的电子问卷,通过微信平台方式对为COVID-19患者实施气管插管术的麻醉医师进行问卷调查,调查时间从2020年2月18日至3月13日。结果:共发放调查问卷120份,收到116份问卷调查,回收率为96.7%。剔除4份无效问卷,有效问卷共112份,有效率为96.6%。参与问卷调查的麻醉医师分布于全国18个省市,其中来自于三级医院的比率为77.7%,二级医院的比率为22.3%,工作年限大于10年的比率为75.9%。行治疗气管插管术的比率为63.4%,行急救气管插管术的比率为36.6%。采取三级防护的比率为76.8%,三级医院采取三级防护的比率高于二级医院(n P<0.05)。麻醉医师采用Mallampati分级对患者进行气道评估的比率为63.4%,采用询问困难气道史、检查颈椎活动情况、测量颏甲间距和门齿间距的方法进行气道评估的比率高于采用Mallampati分级的比率(n P<0.05)。麻醉医师采用快速序贯诱导气管插管的比率为24.1%,使用可视化气管插管工具的比率为94.6%,一次气管插管成功的比率为96.4%。气管插管前使用肌松药的比率为81.2%,与未用肌松药相比,使用肌松药明显提高一次气管插管成功的比率(n P<0.05)。n 结论:目前我国麻醉医师在三级防护下为COVID-19患者行气管插管术尚未完全普及;快速序贯诱导气管插管方式使用率较低;可视化气管插管工具应用广泛;使用肌松药气管插管更适用于该类患者。“,”Objective:To investigate the current status of tracheal intubation performed by Chinese anesthesiologists for the patients with coronavirus disease 2019 (COVID-19) by using a questionnaire.Methods:A self-designed questionnaire was used to carry out a questionnaire survey of anesthesiologists performing tracheal intubation for the patients with COVID-19 through the WeChat platform.The survey time was from February 18 to March 13, 2020.Results:A total of 120 questionnaires were distributed and 116 questionnaires were received, with a recovery rate of 96.7%.Four invalid questionnaires were eliminated, and 112 valid questionnaires were collected, with a valid rate of 96.6%.The anesthesiologists participating in the questionnaire survey were distributed in 18 provinces and cities across the country.Among them, the rate from tertiary hospitals was 77.7%, the rate from secondary hospitals was 22.3%, and the rate for working more than 10 yr was 75.9%.The rate of endotracheal intubation for therapy was 63.4%, and the rate of emergency endotracheal intubation was 36.6%.The rate of adopting tertiary protection was 76.8%, and the rate of adopting tertiary protection in tertiary hospitals was higher than that in secondary hospitals (n P<0.05). The rate of airway assessment by anesthesiologists using Mallampati grading was 63.4%, and the rate of airway assessment using the methods of asking about a history of difficult airways, checking for cervical vertebra movement, and measuring the chin-plate spacing and incisor-tooth spacing was higher than that of Mallampati grading (n P<0.05). The rate of rapid sequence induction and intubation by anesthetists was 24.1%, the rate of using visual endotracheal intubation tools was 94.6%, and the success rate of intubation at first attempt was 96.4%.The rate of using muscle relaxants before intubation was 81.2%.Compared with the rate of no use of muscle relaxants, the use of muscle relaxants significantly increased the success rate of intubation at first attempt (n P<0.05).n Conclusion:Tracheal intubation performed by Chinese anesthesiologists for the patients with COVID-19 under tertiary protection is not yet fully popularized at present.The rate of use of rapid sequence induction and intubation is low.Visualized endotracheal intubation tools are widely used.Using muscle relaxant before endotracheal intubation is more suitable for the patients with COVID-19.