HC可视喉镜在口腔颌面外科困难气道患者经鼻腔气管插管的应用

Application of HC-videolaryngoscopy in nasotracheal intubation for patients with predicted difficult airway undergoing oral maxillofacial surgery

目的:探讨HC可视喉镜在颌面外科困难气道患者经鼻腔气管插管应用的效果。方法:纳入口腔颌面外科需要经鼻腔气管插管进行全麻手术且预计有困难气道的患者70例,随机均分为2组(n=35),分别使用HC可视喉镜(VL组)和Macintosh喉镜(ML组)经鼻腔气管插管。比较2组患者的插管时间、首次插管的成功率,声门暴露的CL分级等插管情况,插管期间的血流动力学指标和插管相关并发症。结果:VL组首次插管的成功率更高插管总时间更少,较少需要多次插管(P<0.05)。插管过程中,VL组首次暴露声门的CL分级和暴露最佳的CL分级优于ML组(P<0.05),较少需要按压喉部和调整头位辅助插管(P<0.05)。ML组中13例患者在首次插管失败后改用可视喉镜插管成功。结论:HC可视喉镜用于颌面外科困难气道经鼻腔气管插管安全、有效。

Objective：To investigate the efficacy of HC-videolaryngoscopy in nasotracheal intubation for patients with predicted difficult airway undergoing oral maxillofacial surgery.Methods：70 patients undergoing oral maxillofacial surgery with predicted difficult airway were enroled and randomly divided into 2 groups（n = 35）.Nasotacheal intubation was performed with HC-videolaryngoscopy（group VL） and Macintosh laryngoscopy（group ML） respectively.The duration and success rate of intubation,degree of glottis exposure,hemodynamic response as well as intubation related complications were evaluated.Results：There was higher success rate of first attempt（P〈0.05）,shorter intubation duration（P〈0.05） and fewer frequency of multiple intubation（P〈0.05） in group VL than in group ML.During intubation,the first and the best Cormack-Lehane laryngeal view was better in group VL（P〈0.05） and less intubation assistance was required in group VL（P〈0.05）.13 patients in group ML were intubated with VL after failure of the first attempt with ML.Conclusion：HC-videolaryngoscopy is safe and effective in the nasotracheal intubation for the patients with predicted difficult airway undergoing oral maxillofacial surgery.