视可尼喉镜两种经鼻插管方式在困难气道中应用对比

Comparison of two nasal intubation modes with shikani optical stylet in difficult airways

目的针对颌面外科困难气道患者,对照使用视可尼喉镜两种经鼻插管方式,评价各自优缺点,为临床使用提供参考。方法选择在经鼻插管全麻下行择期手术的颌面外科患者60例,ASAⅠ~Ⅱ级,张口度1~1.5指,年龄19~55岁,随机分为共进组（A组,n=30）和分离组（B组,n=30）,对比两组一次成功率、插管总耗时、鼻腔出血率、血压心率变化和术后气道并发症发生率。结果两组插管一次成功率、鼻腔出血率、血压心率变化和并发症发生率差异无统计学意义（P〉0.05）,共进组插管总耗时少于分离组（P〈0.05）。结论视可尼喉镜两种插管方式均可成功应用于困难气道经鼻插管,麻醉医师应从舒适化、个体化角度合理选择其一。

Objective To analyse pros and cons of two nasal intubation modes with shikani optical stylet in difficult air-ways, and provide reference for clinical use. Methods Sixty patients aged between 19 and 55 years old with ASA Ⅰ~Ⅱgrade, the mouth opening degree 1~1.5, undergoing elective maxillofacial surgery, were randomly divided into A group （n=30） and B group （n=30）. Successful intubation rate of the first attempt, total time cost of intubation, nasal bleeding rate, changs of blood pressure and heart rate and incidence of postoperative airway complications were compared. Results Compared with group B, the total time cost of intubation in group A was significantly shorter （P〈0.05）, but there was no difference in the other parameters of two groups （P〉0.05）. Conclusion Two nasal intubation modes with shikani optical stylet can be successfully applied for nasal intubation in difficult airways. The anesthesiologist should select the mode according to the comfort of patients and individualized treatment.