目的 分析應(yīng)用右美托咪定滴鼻給藥用于食管癌患者術(shù)前留置胃管的效果。方法 選擇2019年1月—2020年8月秦皇島市第一醫(yī)院中術(shù)前需要置入胃管的擇期食管癌手術(shù)患者84例作為研究對(duì)象，入選患者根據(jù)隨機(jī)數(shù)字表法隨機(jī)分為對(duì)照組（生理鹽水組）和觀察組（右美托咪定組）。對(duì)照組插胃管前30 min生理鹽水1 mL滴鼻并按常規(guī)液狀石蠟處理胃管后置管；觀察組插胃管前30 min用右美托咪定1 μg/kg滴鼻，然后常規(guī)液狀石蠟處理胃管后置管。觀察兩組患者置入胃管時(shí)惡心、嘔吐的發(fā)生率，一次插管成功率，舒適度評(píng)分及血流動(dòng)力學(xué)變化。結(jié)果 插胃管即刻，觀察組心率及平均動(dòng)脈壓顯著優(yōu)于對(duì)照組（P<0.05）。觀察組患者置入胃管過(guò)程中嗆咳、嘔吐等不良反應(yīng)的發(fā)生率及一次置管成功率均顯著優(yōu)于對(duì)照組（P<0.05）。結(jié)論 右美托咪定滴鼻可以安全的作為插入胃管前用藥，可以有效地減輕患者的不適，提高插胃管成功率，為胃管置入方法的選擇提供參考。

Objective To analyze the effect of intranasal dexmedetomidine for indwelling gastric tube in patients with esophageal cancer before operation. Methods A total of 84 patients undergoing elective esophageal cancer surgery who needed gastric tube implantation before operation in the First Hospital of Qinhuangdao from January 2019 to August 2020 were selected as the research subjects. According to the random number table method, selected patients were randomly divided into the control group (normal saline group) and the observation group (dexmedetomidine group). In the control group, 1 mL of normal saline was dripped into the nose 30 min before the implantation of the gastric tube. In the observation group, 1 μg/kg dexmedetomidine was dripped into the nose 30 min before the implantation of the gastric tube, and then the gastric tube was put after the conventional liquid paraffin treatment. The incidence of nausea and vomiting, the success rate of the first intubation, the comfort score and the hemodynamic changes of the patients in two groups were observed. Results Immediately after gastric tube insertion, heart rate and mean arterial pressure in observation group were significantly better than those in control group (P < 0.05). The incidence of adverse reactions such as cough and vomiting during gastric tube implantation and the success rate of one catheter placement in observation group were significantly higher than those in control group (P < 0.05). Conclusion Dexmedetomidine nasal drops can be used safely before gastric tube insertion, and can effectively alleviate the discomfort of patients, improve the success rate of gastric tube insertion, and provide reference for the selection of gastric tube implantation methods.

R982