不同径路气管插管在支撑喉镜声带手术中的应用  

Intubation from different paths in laryngoscope-assisted surgery for vocal cord disease

作　　者：高晓莹[1] 戚思华[1] 李晓光[1] 

机构地区：[1]哈尔滨医科大学附属第四医院麻醉科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2012年第4期376-378,共3页Journal of Harbin Medical University

摘　　要：目的对比经口气管插管与经鼻气管插管在支撑喉镜声带手术中的麻醉效果、安全性及对患者舒适度的影响。方法选择ASA分级Ⅰ～Ⅱ级择期行支撑喉镜声带手术患者80例,随机平均分成Ⅰ组(经口插管组)和Ⅱ组(经鼻插管组)。分别监测:①两组患者入室、插管前、插管后即刻、置入支撑喉镜时SBP、DBP、HR、SpO2、PETCO2值的变化。②两组患者置入支撑喉镜即刻以及术毕撤出支撑喉镜前气管导管在气管内移位的距离。③两组患者手术时间及麻醉苏醒情况。结果两组患者在置入支撑喉镜时均有不同程度的SBP、DBP升高、HR增快,组间比较差异有统计学意义(P<0.05);两组患者在置入支撑喉镜即刻导管内移距离的差异无统计学意义;在术毕撤出支撑喉镜前两组的内移距离相比差异有统计学意义(P<0.05);两组患者手术时间及麻醉苏醒情况相比差异无统计学意义;Ⅱ组拔管时发生呛咳的例数明显少于Ⅰ组,差异有统计学意义(P<0.05)。结论经鼻气管插管全身麻醉对操作影响小,易固定、易耐受,是支撑喉镜下施行声带手术理想的麻醉方法。Objective To evaluate the anesthetic effects, safety and comfort of the patients by orotracheal intubation and nasotracheal intubation in the laryngoscope vocal cord surgery. Methods Eighty patients ASA grade Ⅰ- Ⅱ undergoing elective laryngoscope assisted vocal cord surgery were selected and randomly divided into group I （oral intubation group） and group Ⅱ （nasal intubation group）. The indexes were monitored as follows： ①SBP, DBP, HR, SpO2, PETCO2 value changes before intubation,immediately after intubation, and when the la- ryngoscope into; ②The shift distance of endotracheal tube in the trachea at cing tions laryngoscope and before withdrawing laryngoscope;③Operative time the moment of pla- and waking condi- Results When the laryngoscope into there were varying degrees of increase in SBP, DBP, HR between two groups, differences between groups were statistically significant; the difference of the shift distance of endotracheal tube in the trachea before withdrawing laryngo- scope was statistically significant ; the number of extubation coughing in group Ⅱ was less than that in group Ⅰ - Conclusion General anesthesia by nasal intubation with little impact on the ooeration.easilv fixed, well tolerated, is an ideal surgical anesthesia for vocal cord surgery.

关 键 词：经口气管插管 经鼻气管插管 全身麻醉 声带手术 

分 类 号：R614.2[医药卫生—麻醉学] R767.4[医药卫生—外科学]