硬杆光纤喉镜在鼻咽癌张口受限患者气管插管中的应用  

Optical stylet laryngoscope for orotracheal intubation in nasopharyngeal carcinoma patients with restriction of mouth opening

作　　者：王寿平[1] 陈晓彤[2] 苗利萍[1] 彭书崚[1] 黄子通[3] 

机构地区：[1]中山大学附属孙逸仙纪念医院麻醉科,广州510120 [2]中山大学附属孙逸仙纪念医院ICU,广州510120 [3]中山大学附属孙逸仙纪念医院急诊科,广州510120

出　　处：《中华生物医学工程杂志》2013年第2期151-153,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨在鼻咽癌放疗后张口受限患者使用可视硬杆光纤喉镜引导气管插管的可行性，并评价其使用效果。方法选择2005年1月至2011年12月中山大学附属孙逸仙纪念医院收治的鼻咽癌放射治疗后的手术患者42例（合并张口困难）为对象。对患者行可视硬杆光纤喉镜引导气管插管。观察并记录患者入室时、插管前、插管时、插管成功即刻、插管后5min血压、心率的变化，以及每例的气管插管时间、插管次数以及观察患者呛咳、屏气、口咽腔损伤等不良反应或并发症的发生情况。结果所有患者均插管成功，所有患者均无口咽腔损伤等不良反应，无明显的呛咳反应。与入室时比较，插管时、插管成功即刻血压、心率有显著性升高，但是均在正常的生理范围内。结论可视硬杆光纤喉镜为困难气道管理提供了一种有效的解决手段，在张口受限等方面有突出的优势，使用快捷、携带方便，心血管反应轻，成功率高。Objective To investigate the feasibility and effect of optical stylet laryngoscope for orotracheal intubation in nasopharyngeal carcinoma patients with restriction of mouth opening. Methods Forty-two nasopbaryngeal carcinoma patients after radiotherapy with restriction of mouth opening undergoing operation in Sun Yat-sen Memorial Hospital between January 2005 and December 2011 were enrolled in the study. Patients received orotracheal intubation via optical styler laryngoscope. The changes of blood pressure and heart rate prior to entry of the operating room, and prior to, during, immediately following and at 5 min following intubation were monitored. The duration and number of intubation per patient as well as the incidence of adverse events or complications, i.e. hiccups, breath-holding and oral cavity injury, were recorded. Results All the patients were intubated successfully without adverse events. Compared to baseline levels, the blood pressure and heart rate were increased obviously but within normal ranges during and immediately following intubation. Conclusion Characterized by convenience for carriage, mild cardiovascular responses and high successful rate, the optical styler laryngoscope offers an effective approach to resolve the administration of difficult airway, for especially, those with restriction of mouth opening.

关 键 词：喉镜检查 鼻咽肿瘤 插管法 气管内 张口受限 

分 类 号：R614[医药卫生—麻醉学]