帝视内镜和纤维支气管镜用于口腔颌面骨折手术患者经鼻气管插管的比较

Comparison of Disposcope endoscope and fiberbronchoscope for nasal intubation in patients undergoing oral and maxillofacial fracture surgery

目的评估和比较帝视内镜(Disposcope,DS)和纤维支气管镜(FOB)用于口腔颌面骨折手术患者经鼻气管插管的临床效果。方法选择择期行口腔颌面骨折手术患者60例,男32例,女28例,年龄18~65岁,ASAⅠ或Ⅱ级。患者随机分为DS组和FOB组,每组30例。两组均采取经鼻气管插管,DS组采用DS引导插管,FOB组采用FOB引导插管。记录插管时间、首次插管成功率、插管总成功率。记录术后24h患者声音嘶哑、咽痛、黏膜损伤、牙齿松动等不良反应发生情况。结果 DS组插管时间明显短于FOB组(P<0.05)。两组首次插管成功率和插管总成功率差异无统计学意义。两组术后24h声音嘶哑、咽痛、黏膜损伤、牙齿松动发生率差异均无统计学意义。结论DS或FOB均有助于口腔颌面骨折手术患者经鼻气管插管,两者插管成功率和插管相关并发症相似,但使用DS插管时间较FOB缩短,且操作和维护方便,可在基层医院推广应用。

Objective To evaluate and compare the clinical application of Disposcope endoscope and fiberbronchoscope for nasal intubation in patients undergoing oral and maxillofacial fracture surgery.Methods Sixty patients undergoing oral and maxillofacial fracture surgery,32 males and 28 females,aged 18-65 years,ASA physical status Ⅰ orⅡ,were included in this study.The patients were randomly divided into Disposcope group（group DS,n = 30）and fiberbronchoscope group（group FOB,n = 30）.Both groups were treated with nasal intubation.The patients in group DS were intubated with Disposcope,and group FOB were intubated with fiberbronchoscope.The time of intubation,the success rate of single intubation and the total success rate of intubation were recorded.After 24 hof operation,hoarseness,sore throat,mucosal damage,loose teeth and other related complications were recorded.Results The intubation time of the group DS was significantly shorter than that of the group FOB（P 〈0.05）,there was no significant difference between the two groups in the success rate of single intubation and the total success rate of intubation.There was no significant difference between the two groups in the rate of hoarseness,sore throat,mucosal damage,loose teeth.Conclusion Both Disposcope and fiberbronchoscope are helpful to the nasal trachea intubation in the patients undergoing oral and maxillofacial fracture surgery,the success rate of intubation and intubation related complications were similar,but Disposcope endoscopy has shortened intubation time,and is convenient to operate and maintain.