检验医学与临床Issue(23)：3474-3476,3.DOI:10.3969/j.issn.1672-9455.2015.23.010
盲探气管插管装置在口腔颌面骨折手术麻醉经鼻气管插管的意义
Application significance of blind tracheal intubation instrument in the nasotracheal intubation anesthesia for oral maxil-lofacial fractures
摘要
Abstract
Objective To investigate the application significance of blind tracheal intubation instrument (BTII) in the nasotracheal intubation anesthesia for oral maxillofacial fractures .Methods 90 cases of patients treated with open reduction and internal fixation for maxillofacial fractures after general anaesthesia and American Society of Anethesiology (ASA) Ⅰ - Ⅱ were selected and divided into 3 groups .All of the patients were treated with awake nasal intubation operated by professional persons .Group Ⅰ received traditional blind transnasal tracheal intubation , according to the air sound of breath .Group Ⅱ received endotracheal intubation under fiberoptic bronchoscope through nose .Group Ⅲ received endotracheal intubation under BTII .HRs ,SBPs and DBPs before intubation (T0 ) ,at the intubation(T1 ) and 5 min after intubation (T2 ) were recorded ,and the one‐time successful rates of intubation ,the failure rates ,the spent‐time of successful intubation and the complications of 3 groups were also recorded .Results (1)The HR ,SBP and DBP of 3 groups at T1 were significantly higher than those at T0 and T2 (P< 0 .05) .There was no significant difference of SpO2 at each time point among 3 groups (P> 0 .05) .(2)The one‐time successful rates of intubation of group Ⅰ ,Ⅱ and Ⅲ were 50 .0% ,96 .7% and 93 .3% respectively ,which of group Ⅰ was significantly different from group Ⅱ and Ⅲ (P < 0 .05) ,and there was no significant difference between group Ⅱ and Ⅲ (P >0 .05) .(3)The failure rates of group Ⅰ ,Ⅱ and Ⅲ were 26 .7% ,0 .0% and 3 .3% respectively ,which of group Ⅰ was significantly different from group Ⅱ and Ⅲ (P< 0 .05) ,and there was no significant difference between group Ⅱ andⅢ (P> 0 .05) .(4)The spent‐time of successful intubation of group Ⅰ ,Ⅱ and Ⅲ were (94 .1 ± 14 .0) ,(64 .6 ± 7 .8) and (65 .3 ± 9 .1)s respectively ,which of group Ⅰ was significantly different from group Ⅱ and Ⅲ (P< 0 .05) ,and there was no significant difference between group Ⅱ and Ⅲ (P> 0 .05) .(5)The complications occurred in 3 groups after intubation .There were 12 ,2 and 4 cases with nasopharyngeal hemorrhage and 8 ,1 and 3 cases with sore throat respectively in group Ⅰ ,Ⅱ and Ⅲ .Conclusion It is safety ,simple and reliable to use BTII in the nasotracheal intu‐bation anesthesia for oral maxillofacial fractures ,which is worthy to be promoted and applied in clinical .关键词
口腔颌面骨折/经鼻气管插管/纤维支气管镜/盲探气管插管装置Key words
oral maxillofacial fractures/nasotracheal intubation/bronchofiberscope/blind tracheal intu-bation instrument引用本文复制引用
彭健泓,廖荣宗,余建华,刘莱莉..盲探气管插管装置在口腔颌面骨折手术麻醉经鼻气管插管的意义[J].检验医学与临床,2015,(23):3474-3476,3.基金项目
广东省佛山市卫生局医学科研资助项目（2012149）。 （）
