目的 分析应用右美托咪定滴鼻给药用于食管癌患者术前留置胃管的效果。方法 选择2019年1月—2020年8月秦皇岛市第一医院中术前需要置入胃管的择期食管癌手术患者84例作为研究对象，入选患者根据随机数字表法随机分为对照组（生理盐水组）和观察组（右美托咪定组）。对照组插胃管前30 min生理盐水1 mL滴鼻并按常规液状石蜡处理胃管后置管；观察组插胃管前30 min用右美托咪定1 μg/kg滴鼻，然后常规液状石蜡处理胃管后置管。观察两组患者置入胃管时恶心、呕吐的发生率，一次插管成功率，舒适度评分及血流动力学变化。结果 插胃管即刻，观察组心率及平均动脉压显著优于对照组（P<0.05）。观察组患者置入胃管过程中呛咳、呕吐等不良反应的发生率及一次置管成功率均显著优于对照组（P<0.05）。结论 右美托咪定滴鼻可以安全的作为插入胃管前用药，可以有效地减轻患者的不适，提高插胃管成功率，为胃管置入方法的选择提供参考。

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