帝视可视喉镜在颌面部手术经鼻气管插管中的应用

Application of Emperor Visual Laryngoscope through Nasal Trachea Intubation in Maxillofacial Surgery

目的观测帝视可视喉镜在颌面部手术经鼻气管插管中的应用效果。方法收集2015年1月—2016年12月间接受颌面部手术患者106例,按照便利抽样法将患者分为对照组与观察组各53例。对照组经鼻气管插管过程使用常规Mocintosh直接喉镜插管,观察组使用帝视可视喉镜辅助插管。评价两组的插管时间、一次插管成功率、插管后咽痛发生情况及舒适度评分。结果观察组的插管用时为(38.23±8.24)s,对照组为(50.18±10.19)s,显示观察组插管用时优于对照组(t=6.639,P=0.000)。观察组插管一次成功率为94.34%(50例),对照组为88.68%(47例),结果无统计学意义,P>0.05;观察组咽痛发生率为11.32%(6例),低于对照组30.19%(16例)(χ~2=10.825,P=0.001)。观察组对置管期间舒适度评分为(6.23±0.51)分、对照组评分为(4.01±0.31)分,(t=27.080,P=0.000)。观察组采用喉部暴露Cormark-Lehane分级进行评估I级例数所占百分比优于对照组(χ~2=20.917,P=0.000)。结论帝视可视喉镜应用于颌面部手术经鼻气管插管无需挑起会厌部,置管力度轻柔,对咽喉处刺激较小,引起插管刺激反应较轻,插管后咽痛发生率较低,且插管用时较短,舒适度较优;患者一次插管成功率较高。

Objective To observe the effect of emperor visual laryngoscope in the operation of maxillofacial surgery through nasal trachea intubation. Methods Using convenience sampling method,106 cases who received maxillofacial surgeries from Jan. 2015 to Dec. 2016 in our hospital were selected. The patients were divided into two groups,including 53 cases in the control group and other 53 in the observation group. The patients in the control group were applied with conventional Mocintosh laryngoscope during the course of direct nasal trachea intubation,while those in the observation group received intubation assisted with emperor visual laryngoscope. Intubation time,one-time success rate,incidence of sore throat after intubation as well as comfort scores were compared between the two groups. Results The intubation time in observation group was（ 38. 23 ± 8. 24） s,while it was（ 50. 18 ± 10. 19） s in the control group,which indicated a shorter time in the observation group than that of the latter（ t = 6. 639,P = 0. 000）. One-time success rate for intubation in the observation group was 94. 34%（ 50 cases）,while the rate in the control group was 88. 68%（ 47 cases）,which had no statistics significance（ P 0. 05）. The incidence of sore throat in the observation group was 11. 32%（ 6 cases）,lower than 30. 19%（ 16 cases）in the control group（ χ~2= 10. 825,P = 0. 001）. The comfort score of the observation group was（ 6. 23 ± 0. 51） points,and the score of the control group was（ 4. 01 ± 0. 31） points（ t = 27. 080,P = 0. 000）. The percentage of patients with Cormark-Lehane classification I in the observation group was better than that in the control group（ χ~2= 20. 917,P = 0. 000）. Conclusion The main advantages of the application of laryngeal visual laryngoscope in maxillofacial surgery include no need lifting the epiglottis,gentle insertion of the tube,moderate irritation to the throat,mild stimulation caused by intubation,lower incidence of sore throat,shorter intubation time and better comfort scores and higher one-time success rate for intubation,