在气管插管全麻患者计划准备中使用整骨矫正的理由

V. L. Kurnoskin, O. I. Kurbatov
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However, there are no publications in the available literature on osteopathic correction of patients at high risk of intubation in order to reduce the risk degree.The aim of the research is to substantiate the use of osteopathic correction in the planned preparation of patients for general anesthesia with tracheal intubation.Materials and methods. The study involved 30 patients with chronic surgical pathology of internal organs who had to undergo elective surgery. The patients were distributed into the control and main groups (15 participants each) by the method of randomization envelopes. The participants of the control group followed the instructions given by the anesthetist, the participants of the main group received additionally a month before the operation two sessions of osteopathic correction with an interval of 14 days. In both groups, the osteopathic status was assessed before the start of the corresponding treatment. The degree of intubation risk and the incision distance were also assessed. After completion of the corresponding treatment, the osteopathic status was re-evaluated in both groups. In the main group, the risk of intubation and the incision distance were re-evaluated.Results. At the beginning of the study, both groups were characterized by a high detection frequency of the following regional biomechanical disorders: neck, thoracic region and dura mater. At the completion of the study, a statistically signifi cant (p<0,05) decrease in the detection frequency of all these disorders was observed in the main group. There was no signifi cant dynamics in the control group. Also in the main group there was a statistically signifi cant (p<0,05) decrease in the intubation risk and an increase in the incision distance value.Conclusion. 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引用次数: 0

摘要

介绍。气管插管失败的风险是一个重要的问题,择期外科手术与全身麻醉和气管插管。考虑到发展短期外科医院的趋势,以及内窥镜检查服务的可得性相当低,需要寻找使患者为成功气管插管做好准备的替代方法。参与颞下颌关节工作的肌肉的正常张力以及舌骨上方和舌骨下方肌肉的张力对于气管插管的成功是必要的。根据现代观念,可以假设对上述解剖结构进行适当的整骨疗法可以减少肌肉张力。然而,在现有的文献中,没有关于骨科矫治高风险插管患者以降低风险程度的出版物。本研究的目的是证实整骨矫正在气管插管全麻患者计划准备中的应用。材料和方法。该研究涉及30名患有慢性内脏外科病理的患者,他们不得不接受选择性手术。采用随机信封法将患者分为对照组和主要组各15例。对照组患者按照麻醉师的指导进行治疗,主组患者在术前一个月额外进行两次骨科矫正,每隔14天进行一次。在两组患者中,在开始相应的治疗前评估其骨病状态。评估插管风险程度和切口距离。在完成相应的治疗后,对两组患者的骨科状况进行重新评估。主组重新评估插管风险和切口距离。在研究开始时,两组的特点都是以下区域生物力学障碍的高检出率:颈部、胸部和硬脑膜。研究结束时,主组患者上述疾病的检出率均有统计学意义(p< 0.05)的下降。对照组没有明显的动态变化。主组患者插管风险降低,切口距离值增高,差异均有统计学意义(p< 0.05)。获得的结果允许在插管高风险患者的计划准备期间推荐预约整骨师咨询和整骨矫正。同时,建议继续在更大的样本上进行研究。
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Justifi cation of the use of osteopathic correction in the planned preparation of patients for general anesthesia with tracheal intubation
Introduction. The risk of unsuccessful intubation is a signifi cant problem during elective surgical operations with general anesthesia and tracheal intubation. Taking in consideration the trend towards the development of short-stay surgical hospitals, and the rather low availability of endoscopy services, the search for alternative methods of preparing patients for successful tracheal intubation is in demand. A normal tone of the muscles involved in the work of the temporomandibular joints as well as the tone of the muscles above the hyoid bone and the muscles below the hyoid bone are necessary for successful intubation of the trachea. Based on modern ideas, it can be assumed that an adequate osteopathic effect on the mentioned anatomical structures can provide a decrease in muscle tone. However, there are no publications in the available literature on osteopathic correction of patients at high risk of intubation in order to reduce the risk degree.The aim of the research is to substantiate the use of osteopathic correction in the planned preparation of patients for general anesthesia with tracheal intubation.Materials and methods. The study involved 30 patients with chronic surgical pathology of internal organs who had to undergo elective surgery. The patients were distributed into the control and main groups (15 participants each) by the method of randomization envelopes. The participants of the control group followed the instructions given by the anesthetist, the participants of the main group received additionally a month before the operation two sessions of osteopathic correction with an interval of 14 days. In both groups, the osteopathic status was assessed before the start of the corresponding treatment. The degree of intubation risk and the incision distance were also assessed. After completion of the corresponding treatment, the osteopathic status was re-evaluated in both groups. In the main group, the risk of intubation and the incision distance were re-evaluated.Results. At the beginning of the study, both groups were characterized by a high detection frequency of the following regional biomechanical disorders: neck, thoracic region and dura mater. At the completion of the study, a statistically signifi cant (p<0,05) decrease in the detection frequency of all these disorders was observed in the main group. There was no signifi cant dynamics in the control group. Also in the main group there was a statistically signifi cant (p<0,05) decrease in the intubation risk and an increase in the incision distance value.Conclusion. The obtained results allow recommending the appointment of an osteopath consultation and osteopathic correction during the planned preparation of patients with a high risk of intubation. At the same time, it is recommended to continue the study on a larger sample.
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