纤维支气管镜和Shikani喉镜联合成像系统引导颈椎制动患者经鼻气管插管的比较研究

Use of imaging systems coupled with Shikani optical stylet and fiberoptic bronchoscopy to guide nasotracheal intubation in patients with cervical spine immobilization

目的 比较Shikani喉镜（shikani optical stylet,SOS）与纤维支气管镜（fiberoptic bronchoscope,FOB）用于颈椎制动患者引导经鼻气管插管的临床效果,探讨SOS在经鼻气管插管的应用价值. 方法 40例颈椎制动需经鼻气管插管全身麻醉的手术患者采用随机数字表法分为SOS引导气管插管组（SOS组,20例）和FOB引导气管插管组（FOB组,20例）,分别采用SOS和FOB接视频成像系统后行经鼻气管插管.记录气管插管次数、气管插管时间、血流动力学参数变化和鼻咽部黏膜损伤情况. 结果 两组患者的一般资料、插管次数、气管插管时间、插管成功率、插管反应及黏膜损伤情况比较,差异无统计学意义（P〉0.05）. 结论 联合成像系统的SOS引导气管插管,是一种成功率高、损伤小、安全性高的经鼻气管插管方法 .

Objective To compare therapeutic efficiency of imaging systems coupled with shikani optical stylet （SOS） and fiberoptic bronchoscopy（FOB）for nasotracheal intubation in patients with cervical spine immobilization. Methods Forty cases with cervical spine immobilization,who were evaluated ASA grade Ⅱ-Ⅲand required nasotracheal intubation,were randomly divided into SOS guided intubation group （group SOS） and FOB guided intubation group （group FOB）. Both SOS and FOB were connected to an imaging system to guide endotracheal intubation. We also collected information, such as, number of attempts to obtain successful intubation, time periods to complete intubation, hemodynamic parameters, and the incidence of nasal mucosal injury. Results No significant difference was founded on demographic data between these two groups. The number of attempts to obtain successful intubation,time period to complete intubation,and complications in group SOS were not statistically different from those in group FOB （P〉0.05）. Conclusions Imaging system-assisted guidance is helpful to improve success rate, and minimize injury of nasal tracheal intubation.