光棒引导经鼻插管在张口困难患者中临床应用  

Application of nasotracheal intubation using lightwand in patients with difficulty in opening mouth

作　　者：邵云[1] 董迎春[1] 王新河[1] 苏荣祥[1] 李刚[1] 顾小萍[2] 

机构地区：[1]南京大学医学院附属口腔医院,210008 [2]南京大学医学院鼓楼医院,210008

出　　处：《实用口腔医学杂志》2013年第5期718-720,共3页Journal of Practical Stomatology

基　　金：南京市医学科技发展资金资助(编号:YKK11040,QRX11123)

摘　　要：目的：探讨光棒引导经鼻气管插管在张口困难患者中应用的可行性。方法-选择82例口腔颌面外科张口困难（张口度〈2．5cm）患者，在快诱导麻醉下由光棒引导经鼻气管插管。记录患者麻醉诱导前后、插管过程中和插管后的SBP、DBP和HR。记录插管成功时的插管次数、插管时间及术后24h并发症发生率。结果：82例患者中，53例（64．6％）一次性插管成功，29例（35．4％）经2～3次插管成功。插管操作时间（75．4±26．4）S。与诱导前相比，插管时的BP和HR．差异无显著性。术后随访2例有轻微咽部不适，1例主诉咽喉疼痛。结论：光棒引导经鼻气管插管对血流动力学影响轻微，口咽部损伤小，成功率高，在张口困难患者中值得推广应用。Objective： To evaluate the feasibility of lightwand in nasotracheal intubation in patients with difficulty in opening mouth. Methods ： 82 patients with mouth opening less than 2.5 cm in oral and maxillofacial surgery- were involved in the study. Nasotracheal Intubation was conducted using lightwand under rapid sequence induction. SBP, DBP, HR at different time points, total intubation attempts, intubation time and postoperative adverse effects were recorded. Results ： The lightwand intubation was successful in all pa- tients, among them 53 patients（64.6% ） were intubated on the first attempt, and 29（35.4% ） on the second or third attempt. The intubation time was （75.4 ± 26.4） s. There were no significant differences of SBP, DBP and HR during intubation compared to base values. There were light pharyngeal discomfortability in 2 cases and pharyngalgia in 1 case. Conclusion： Lightwand-guided nasotra- cheal intubation deserves further clinical application in patients with difficult mouth opening due to high success rate, stable haemody- namics and fewer injuries.

关 键 词：光棒 张口困难 快诱导 经鼻气管插管 

分 类 号：R782.054[医药卫生—口腔医学]