|
| 中国医疗机构困难气道的调查与分析 |
| Investigation and analysis of difficult airways in medical institutions in China |
| |
| DOI：10.12089/jca.2020.04.014 |
| 中文关键词: 气道管理 问卷调查 困难气道 |
| 英文关键词: Airway management Questionnaire Difficult airway |
| 基金项目:国家自然科学基金（81673922）；广州市科技计划项目（201707010297） |
|
| 摘要点击次数: 3504 |
| 全文下载次数: 913 |
| 中文摘要: |
目的 通过网络问卷对全国31个省、市、自治区的医疗机构气道管理情况进行调查。
方法 拟定一份有关气道管理情况的网络调查问卷，包含9大类63个问题，通过微信发放和回收。
结果 回收问卷1 935份，有49.7%的被调查者来自三级医院，主治医师及以上占75.7％。63.2％的参与者曾因困难气道而取消或延迟手术。13.8％调查者所在医院发生过因困难气道导致严重不良事件(患者死亡或脑损伤等)。肥胖(26.2%)是困难气道最常见原因。对已预见的困难气道，选择全麻快速诱导比例达16.9%。未阅读ASA和CSA困难气道管理流程比例为34.3%和6.8%。对于未预料困难气道，盲探3次及以上的比例为2.5%。手术室外插管时，69.8%的参与者认为最担心困难气道。36.1%的参与者曾使用过颈前急救技术抢救患者。最常采用的技术是环甲膜穿刺技术，达74.4%。73.0%配备可视喉镜，可视插管软镜（含纤维支气管镜和电子镜）比例达到52%，气道急救箱或急救车比例34.1%。79.8%的医师经历过拔管后再插管。仅50.9%参加过气道管理培训。
结论 气道工具配备虽有明显改善，但因困难气道导致的严重并发症依然存在；紧急气道急救工具普遍缺乏，困难气道管理培训有待普及，困难气道管理仍然需不断改善。 |
| 英文摘要: |
Objective To investigate the airway management of medical institutions in 31 provinces, municipalities and autonomous regions across the country, an online questionnaire was used.
Methods Send and retrieve an online questionnaire on airway management through WeChat, including 63 questions in 9 categories.
Results A total of 1 935 questionnaires were collected, 49.7% of the respondents came from Level III hospitals, and 75.7% of the respondents were attending physicians and above. 63.2% of the participants had cancelled or delayed the operation due to difficult airway. 13.8% had had serious adverse events caused by difficult airway (patient death or Cerebral hypoxia, etc.). Obesity was the most common cause of difficult airway. For the predicted difficult airway, the proportion of rapid sequence induction intubation (RSII) was 16.9%. The proportion of difficult airway management algorithms without reading ASA and CSA was 34.3% and 6.8% respectively. For unanticipated difficult airway, the proportion of blind intubation for 3 times or more was 2.5%. When intubating outside the operating room, 69.8% of the participants thought they were most worried about difficult airway. 36.1% of the participants had used pre-neck first aid technology to rescue patients.73.0% of respondents were equipped with video laryngoscope, 52% were equipped with video inflexible intubating scope (VFIS, including FOB), and 34.1% were equipped with airway carts or boxes. 79.8% of the respondents encountered the cases of re-intubation. Only 50.9% had attended airway management training.
Conclusion Although airway tools have been significantly improved, serious complications caused by difficult airway still exist. emergency airway first aid tools are generally lacking, difficult airway management training needs to be popularized, and difficult airway management still needs to be improved. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
