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Received:August 10, 2019 Published Online:December 23, 2019
Received:August 10, 2019 Published Online:December 23, 2019
中文摘要: 目的 探讨头端塑形软质纤维光索在经鼻气管插管中应用的安全性及有效性。方法 选取2018年6月至2019年5月耳鼻喉科择期在全身麻醉下行扁桃体切除术或声带息肉切除术患者90例,年龄≥18岁,ASA Ⅰ级或Ⅱ级,Mallampati分级为Ⅰ~Ⅲ级,体质指数(BMI)≤32,随机分为软质光索组(F组)、硬质光棒组(S组)、普通直接喉镜组(L组)三组,每组各30例。记录首次插管成功例数、插管总成功例数、首次插管时长,插管过程中口、鼻、咽部黏膜及患者牙齿出血损伤情况,观察并记录麻醉诱导前、麻醉诱导后、首次气管插管过程中以及插管完成后2 min时的血压和心率。术后随访患者咽痛、声音嘶哑等不良反应发生情况。结果 三组患者插管总成功率均为100%。首次插管成功率F组(96.67%)、S组(93.33%)、L组(76.67%)三组间差异有统计学意义(P<0.05),F组最高;首次插管时长三组间差异有统计学意义(P<0.01),F组用时最短;术中及术后并发症发生率F组(3.33%)、S组(20.00%)、L组(30.00%)三组间差异有统计学意义(P<0.05),F组最低。结论 软质纤维光索用于经鼻气管插管操作简单,插管快速、安全,成功率高,插管过程中血流动力学平稳。
Abstract:Objective To investigate the safety and effectiveness of the application of the flexible shaped-lightwand in nasotracheal intubation. Methods A total of 90 patients who received tonsillectomy or vocal polypectomy under general anesthesia at E.N.T.Department from June 2018 to May 2019 were selected.All the patients were older than 18 years,ASA grade was Ⅰ or Ⅱ,Mallampati grade was Ⅰ to Ⅲ,BMI ≤32.The patients were divided into flexible shaped-lightwand group(group F),traditional lightwand group(group S) and laryngoscope group(group L) randomly (n=30,each).The number of successful intubation for the first time,the total number of successful intubation,the first intubation time,the bleeding and injury of mouth,nose,pharyngeal mucosa and patients′ teeth during intubation were recorded,the blood pressure and heart rate were observed and recorded before anesthesia induction,after anesthesia induction,during the first intubation and 2 minutes after intubation.The adverse reactions such as sore throat and hoarseness were followed up after operation. Results The total success rate of intubation was 100%in all the three groups.The differents in success rate of the first intubation between group F (96.67%),group S (93.33%) and group L (76.67%) was statistically significant (P<0.05),and the highest in group F;the difference in the first intubation time between the three groups was statistically significant (P<0.01),and the shortest in group F;the incidence of complications during and after operation in group F (3.33%),group S (20.00%) and group L (30.00%) was statistically significant (P<0.05),and the lowest in group F. ConclusionThe flexible shaped-lightwand used in nasotracheal intubation has the advantages of simple operation,fast and safe intubation,high success rate and stable hemodynamics during intubation.
keywords: Nasotracheal intubation Flexible shaped-lightwand Tonsillectomy Vocal polypectomy Anesthesia Intubation success rate
文章编号: 中图分类号:R 614 文献标志码:B
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