"曲芯转向"经鼻气管插管术的回顾性临床研究  

Clinical efficacy of a novel technique of nasotracheal intubation under video laryngoscopy

作　　者：童易如 张号绒 王国庆 李红云 杜晶慧 顾志清 Liu Henry Tong Yiru;Zhang Haorong;Wang Guoqing;Li Hongyun;Du Jinghui;Gu Zhiqing;Liu Henry(Department of Anesthesiology,Shanghai Children's Hospital,School of medicine,Shanghai Jiao Tong University,Shanghai 200062,China;Department of Ultrasonography,Shanghai Children's Hospital,School of medicine,Shanghai Jiao Tong University,Shanghai 200062,China;Department of Anesthesiology&Critical Care,Perelman School of Medicine,University of Pennsylvania,Philadelphia,PA 19102,USA)

机构地区：[1]上海市儿童医院麻醉科,上海交通大学医学院,上海200062 [2]上海市儿童医院超声科,上海交通大学医学院,上海200062 [3]宾夕法尼亚大学佩雷尔曼医学院麻醉与重症监护科,费城19102

出　　处：《临床小儿外科杂志》2023年第12期1184-1188,共5页Journal of Clinical Pediatric Surgery

基　　金：上海市儿童医院科研基金资助(2020YLY05)

摘　　要：目的探讨"曲芯转向"经鼻气管插管术是否具有减少经鼻气管插管中鼻腔出血的作用。方法回顾性分析2016年5月至2022年12月上海市儿童医院由同一麻醉医师实施的40例经鼻气管插管患儿临床资料,根据经鼻气管插管过程中是否使用"曲芯转向"经鼻气管插管术分为新技术组和常规技术组,每组各20例。收集并对比分析两组患儿年龄、性别、体重、气管导管内径、首次插管成功率、鼻出血发生情况及气管插管主观分类印象等。结果新技术组与常规技术组气管导管内径分别为4.4(4.0,5.0)mm、4.6(4.0,5.0)mm,差异无统计学意义(P>0.05)。新技术组首次插管成功率高于常规技术组(90%比60%),差异有统计学意义(P<0.05);鼻出血的发生率低于常规技术组(15%比45%),差异有统计学意义(P<0.05);气管插管主观印象容易构成比较常规技术组更高(95%比65%),差异有统计学意义(P<0.05)。结论视频喉镜下"曲芯转向"经鼻气管插管术可以提高首次插管成功率,减少经鼻气管插管所致的鼻腔出血。Objective To explore whether or not a novel technique of nasotracheal intubation under video laryngoscopy might minimize epistaxis during nasotracheal intubation.Methods From May 2016 to December 2022,retrospective review was performed for the relevant clinical data of 40 children undergoing nasotracheal intubation by the same anesthesiologist at Shanghai Children's Hospital.Age,gender,body weight,size of endotracheal tube,success rate of initial intubation,presence of epistaxis during intubation and subjective classification impression of intubation were recorded.They were assigned into two groups of novel technique and conventional technique based upon the specific mode of intubation(n=20 each).The authors examined whether or not the novel technique could boost success rate of initial intubation and minimize epistaxis.Results No significant inter-group difference existed in inner diameter of tracheal catheter[M(Q 1,Q 3),4.4(4.0,5.0)vs.4.6(4.0,5.0)mm,P>0.05].The success rate of initial intubation was higher in novel technique group than that in conventional technique group(90%vs.60%,P<0.05).Yet the incidence of epistaxis was lower than that in conventional technique group(15%vs.45%,P<0.05).Subjective impression of intubation was more convenient than that in conventional technique group(constituent ratio,95%vs.65%,P<0.05).Conclusions The novel technique of nasotracheal intubation under video laryngoscopy can improve the success rate of initial intubation and reduce epistaxis during intubation.

关 键 词：插管法 气管内 对比研究 儿童 

分 类 号：R726.5[医药卫生—儿科]