摘要
目的 :研制更加适合诊治咽腔、口腔疾患的开口器及固定支架。方法 :冷光源开口器由臂、体、压舌板、冷光源及配套固定支架构成 ,压舌板末端形成“U”形 ,两臂宽度恰好容纳麻醉导管 ,在“U”形压舌板两臂背面中部凿出直径 3mm的纵行沟槽 ,冷光源导光纤维插入其内 ,配制两臂插在手术床两侧滑道上的螺母 ,可前、后、上、下移动 ,上方附有器械托盘的固定支架。应用传统的Davis开口器和冷光源开口器各行手术 30例 ,对比术中出血、开口器脱出、手术时间及术后并发症的发生率。结果 :冷光源开口器将光线直接导入术区 ,光照充足 ,术野清晰 ,麻醉导管固定在舌与压舌板之间 ,既移开了障碍物 ,又保持了通畅。固定支架固定牢靠 ,器械托盘方便手术。两组病例各项指标经统计学处理差异有显著性 (P <0 .0 5 ) ,说明冷光源开口器明显优于传统Davis开口器。结论 :冷光源开口器及其固定支架可免戴头灯 ,合理固定麻醉导管 ,配套支架的应用缩短了手术时间 ,减少了并发症的发生 ,并避免了预置性气管切开术 。
Objective:To make more adaptive mouth gag and constant frame used in treatment of nasopharyngeal and oropharyngeal diseases. Method:Spatula of Davis-gag was modified into'U' shape in which anesthesia tube was wedged.Two cold light fibers went through 3mm width slots respectively in each posterior brachial region of the 'U' shape.The width of frame with pad above was made in accordance with operation beds.The frame could move upward,downward,forward and backward under the control of screws.30 patients with pharyngopathy were treated with Davis-gag and the other 30 patients with cold light resource gag.Bleeding amount and gag's slide,operation time and complication were compared.Result:Using cold light resource gag,operator obtained direct field and full light.Anesthesia tube was fixed between tongue and spatula,to avoid obstruction of the tube interference to the operation.Statistical result demonstrated that there was significant difference between the two groups' operations and complications.It was illustrated that cold light resource gag was superior to the Davis gag. Conclusion:Usage of cold light resource gag and its fixture without head lamp not only reduce operation time and complication but also avoid preventive tracheotomy.The cold light resource gag is advisable to be carried in the practice.
