纤维支气管镜引导经口气管插管避免上门齿部分缺失损伤的临床观察

Tracheal intubation with fiberoptic bronchoscopy guide prevents tooth injury in patient with front teeth missing

目的 研究纤维支气管镜引导经口气管插管避免上门齿部分缺失患者牙齿损伤的效果.方法 选择100例ASA 1～3级、上门齿部分缺失需择期手术行经口气管插管全身麻醉的患者,随机分为两组,常规喉镜气管插管对照组（A组）和纤维支气管镜引导气管插管组（B组）,每组50例.A组常规用咽喉镜暴露声门行气管插管,B组纤维支气管镜引导下气管插管.分别纪录插管所用时间（秒）、需两次或两次以上插管例数、牙龈出血例数、术后24小时发生牙齿损伤情况.结果 两组插管所用时间（秒）、需两次或两次以上插管例数、牙龈出血例数、术后24小时发生牙齿损伤差异均有显著性（P＜0.05）.其中A组插管时间明显小于B组（P＜0.05）,但是A组比B组更易发生两次或两次以上插管,A为32.00％,B为10.00％,组间差异显著（P=0.007）,A组比B组更易在插管中发生牙龈出血,A组为34.00％,B组为8.00％,组间差异显著（P=0.001）,A组比B组更易发生牙齿损伤,A组为20.00％,B组为4.00％,组间差异有统计学意义（P=0.04）.结论 纤维支气管镜引导经口气管插管用于上门齿部分缺失患者,能够有效避免牙齿损伤,并减少两次或者两次以上气管插管的发生.

Objective To investigate the results of fiberoptic bronchoscopy guide tracheal intubation by mouth prevention of tooth injury for patient with front teeth missing.Methods 100 patients with front teeth missing were performed general anesthesia with tracheal intubation by mouth.The ASA were 1-3 grades.All cases were randomized into conventional laryngoscope group （group A,n=50） and fiberoptic bronchoscopy group （group B,n=50）.The following variables were analyzed,including intubation time required,more than twice intubation,gingival bleeding,tooth injury after post-operation 24 hours.Results The intubation time in Group A was significantly shorter than that in Group B（P ＜0.05）,but the incidence of intubation of in Group B was more than twice lower than that in Group A （P=0.007）.The incidence of gingival bleeding in tracheal intubation in Group B was significant lower than that in Group A （P=0.001）.The incidence of tooth injury in Group B was lower than that in Group A（P=-0.014）.Conclusion The tracheal intubation with fiberoptic bronchoscopy guide can prevention of tooth injury for patient with front teeth missing following general anesthesia,and effectively decrease the incidence of intubation with more than twice.