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| 不同折弯角度可视管芯引导经鼻气管插管效果的比较 |
| Comparison of the effect of different bending angles for nasotracheal intubation with video stylet |
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| DOI：10.12089/jca.2021.06.013 |
| 中文关键词: 可视管芯 经鼻气管插管 折弯角度 |
| 英文关键词: Video stylet Nasotracheal intubation Bending angle |
| 基金项目: |
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| 中文摘要: |
目的 观察不同折弯角度可视管芯引导经鼻气管插管的效果。
方法 选择择期行颌面手术经鼻气管插管的全麻患者120例，男19例，女101例，年龄18～60岁，ASA Ⅰ或Ⅱ级。根据插管时可视管芯前端折弯角度的不同，将患者随机分为三组：70°组、90°组和110°组。记录鼻孔-喉结的垂直距离（简称TND）、插管时间、插管次数、声门显露情况、插管辅助手法以及鼻出血情况。
结果 三组TND差异无统计学意义。90°组、110°组插管时间明显短于70°组，插管成功率明显高于70°组（P<0.05）。90°组、110°组插管时间、插管成功率差异无统计学意义。90°组声门显露级别明显优于70°组和110°组（P<0.05），70°组、110°组声门显露级别差异无统计学意义。三组插管时均采用头后仰的辅助手法，但70°组后仰程度大，而90°组、110°组多为轻度后仰。110°组有1例（2.5%）需辅助提颏，1例（2.5%）需助手辅助托下颌，而70°组则有6例（15.0%）需调整喉部位置。三组鼻出血发生率差异无统计学意义。
结论 可视管芯引导经鼻气管插管时，与70°折弯角度比较，90°折弯角度插管时间更短、成功率更高、插管所需辅助调整更少。110°折弯角度插管时间和成功率和90°折弯角度接近，但需要更多的辅助调整。 |
| 英文摘要: |
Objective To observe the optimal bending angle of stylet for nasotracheal intubation.
Methods A total of 120 patients scheduled for selective maxillofacial surgery under general anesthesia requiring nasotracheal intubation, 19 males and 101 females, aged 18-60 years, ASA physical status Ⅰ or Ⅱ, were enrolled in the study. Patients were assigned into one of three groups according to the bending angle of the stylet: 70° group, 90° group, and 110° group. Nostril-thyroid prominence distance, intubation time, success rates of intubation, glottic view grading, additional maneuvers and epistaxis were recorded.
Results There was no statistically significant difference in nostril-thyroid prominence distance between the three groups. Intubation time in 90° group was similar to that in 110° group, but was shorter than that in 70° group (P < 0.05). Success rates were comparable between the 90° group and 110° group, both of which was higher than that in the 70° group. There was no statistically significant difference in intubation time and intubation success rate between 90° group and 110° group. The glottic view grading was better in 90° group than that in 70° group and 110° group (P < 0.05). There was no statistically significant difference in the level of glottal exposure between the 70° group and the 110° group. The three groups of intubation all adopted the auxiliary technique of head reclining, but the 70° group had a large degree of head back, while the 90° group and the 110° group mostly had a slight head back. In the 110° group, 1 patient (2.5%) required assisted chin lift, 1 patient (2.5%) required an assistant to support the mandible, while 6 patients (15.0%) in the 70° group required adjustment of the larynx position. There was no statistically significant difference in the incidence of epistaxis among the three groups.
Conclusion For the nasotracheal intubation with video stylet, a 90° bending angle can achieve a shorter intubation time, a higher success rates and less additional maneuvers compared to a 70° bending angle. Intubation time and success rates are similar between 110° and 90° bending angle, but more additional maneuvers are required for the 110° bending angle. |
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