光棒在困难气道患者经鼻气管插管中的应用

Application effect of lightwand during nasotracheal intubation in patients with difficult airways

目的探讨光棒在困难气道患者经鼻气管插管中的应用效果。方法选取困难气道且拟行经鼻气管插管患者131例,男62例,女69例,年龄18～60岁,ASAⅠ或Ⅱ级,采用随机数字表法分为纤维支气管镜组(F组,n=66)和光棒组(L组,n=65)。比较两组插管成功率、插管时间及术后插管并发症发生率。结果与F组比较,L组第一次插管成功率[54(83.1%)vs 57(86.4%)]差异无统计学意义,第一次插管时间明显延长[(106.9±29.8)s vs(94.6±26.9)s,P<0.05];第二次插管成功率[7(63.6%)vs 4(44.4%)]差异无统计学意义,插管时间明显缩短[(107.1±21.5)s vs(137.3±19.5)s,P<0.05];插管总成功率[61(92.4%)vs 61(93.8%)]差异无统计学意义。两组患者术后并发症的发生率差异均无统计学意义。结论光棒引导是困难气道患者行经鼻气管插管时的有效技术,可以作为一个应急工具。

Objective To explore the clinical value of lightwand during nasotracheal intubation in patients with difficult airways.Methods One hundred and thirty-one patients with difficult airways who underwent nasotracheal intubation,aged 18-60 years,falling into ASA physical statusⅠorⅡ,were randomly divided into fibrobronchoscopy group(group F,n =66)and lightwand group(group L,n = 65)using random digital table.The success rate of intubation,the intubation time,and the postoperative complications of intubation were recorded.Results Compared to group F,the firsttime success rate of intubation in group L was not significantly different [54(83.1%)vs 57(86.4%)],and the first intubation time was significantly longer in group L [(106.9±29.8)s vs(94.6±26.9)s,P < 0.05];the second-time success rate of intubation in group L was not significantly different[7(63.6%)vs 4(44.4%)]and the second intubation time was significantly shorter in group L [(107.1±21.5)s vs(137.3±19.5)s,P <0.05];the total success rate of intubation in group L was not significantly different[61(93.8%)vs 61(92.4%)].There were no significant differences in the incidence rates of complications between the two groups.Conclusion Lightwand intubation is an effective technique during nasotracheal intubation in difficult airway and may be a substitute when fibrobronchoscopy is absent.