托下颌法辅助光棒下经口气管插管的临床效果

Clinical effects of light-wand guided oral tracheal intubation assisted by jaw thrust methodClinical method

目的对托下颌法辅助光棒气管插管作一初步评价。方法 100名实施择期骨科手术的成年患者随机分成两组行光棒下经口气管插管:A组托下颌法辅助组和B组常规光棒插管组,每组50例。麻醉诱导后行插管操作。观察指标:(1)术前测量张口度(上下切牙间距)、甲颏间距,并评定Mallampati分级。(2)操作情况:置管时间,置管一次成功率。气管插管所致并发症:口齿损伤,咽喉疼痛等。(3)纤支镜通过鼻咽通路观察咽喉部组织对插管操作的影响。结果两组患者最终均获成功,三次以内尝试操作的总成功率均为100%。未见明显并发症。置管时间A组明显短于B组(P<0.05);一次成功率A组高于B组(P<0.05);纤支镜评分A组影响插管操作情况明显低于B组(P<0.05)。结论托下颌法辅助光棒经口气管插管可显著的提高操作的一次性成功率,缩短操作时间。

Objective To make a preliminary evaluation of light-wand guided oral tracheal intubation assisted by jaw thrust meth-od. Methods 100 patients who underwent selective orthopaedic surgery were randomly divided into two groups to receive the light-wand guided oral tracheal intubation. Group A was assisted by the jaw thrust method, and group B received the routine light wand guid-ed intubation with 50 cases in each group. Intubation was carried out after the induction of anesthesia. Observation was made in the in-dexes including：（1） The preoperative mouth opening degree （the distance between upper and lower incisors）, thyromental distance, and Mallampati grades;（2） the intubation results including the intubation time, one-time success rate of intubation, and the complications caused by the intubation such as oral and dental injuries and sore throat, etc;（3） the influence of the observation on tissues of pharynx and larynx under fibro bronchoscopy via the nasopharyngeal passage. Results Intubation was successfully carried out in all the cases. The total success rate of intubation with in three attempts was 100%. No obvious complications occurred. The time for intubation in group A was significantly shorter than that in group B （P〈0.05）. The one-time success rate in group A was higher than that in group B （P〈0.05）. The fibro bronchoscopy scores that demonstrated the degree of influence on the intubation in group A were fewer than those in group B （P〈0.05）. Conclusion Light-wand guided oral tracheal intubation assisted by jaw thrust method can significantly increase one-time success rate of intubation and shorted the operative time.