2种经口气管插管固定方式在口腔内手术中的应用效果评价

Evaluation of two methods for fixation of oral tracheal intubation during intraoral surgery

目的 :设计一种固定经口腔麻醉插管方式,防止术中麻醉插管脱落,提高手术安全性和手术效率。方法 :将80例因鼻腔狭窄,需经口腔插管的口腔内手术患者,随机分为试验组和对照组。试验组中,麻醉插管置于口角,根据手术部位,用4号丝线固定牙体,继而缠绕于插管并打结。对照组中,麻醉插管置于口角,用4号丝线穿针并固定于口角软组织,再与插管打结固定。采用SPSS 19.0软件包对数据进行统计学分析。结果:对照组分别有18例、2例发生导管轻、中度移位,而试验组2例发生导管轻度移位,2组比较差异有统计学意义(P<0.001)。对照组口角轻度损伤11例,试验组未见口角损伤,2组比较差异有统计学意义(P<0.001)。对照组无牙龈损伤,试验组1例牙龈轻度损伤,2组比较差异无统计学意义(P=0.314)。对照组和试验组均无牙稳定性改变。结论:本研究试验组的固定方式,可作为口腔内手术时经口腔麻醉插管的常规固定方式。

PURPOSE: To design a method for fixation of oral tracheal intubation, to prevent anesthetic intubation fall-off during operations, then improving surgical safety and surgical efficiency. METHODS: Eighty patients undergoing intraoral surgery were chosen, who had rhinostenosis and required oral intubation. The patients were randomly divided into experi-mental and control groups. In the experimental group, anesthetic cannulas were placed at the corner of mouth, several teeth were fixed by 4-0 silk thread according to the surgical site, then knotted around the cannulas. In the control group,anesthetic cannulas were placed at the corner of mouth, the soft tissue of mouth were fixed by 4-0 silk thread, then knot-ted around the cannulas. SPSS 19.0 software package was used for statistical analysis. RESULTS: There were 18 patients with mild displacement, two patients with moderate displacement in the control group, while there were two patients with mild displacement in the experimental group, and the difference between the two groups was statistically significant( P<0.001). There were 11 patients with mild oral commissure injury in the control group, while there was no oral commissure injury in the experimental group, and the difference between the two groups was statistically significant( P<0.001). There was no gingival injury in the control group, and there was only one patients with gingival injury in the experimental group,the difference between the two groups was not statistically significant(P=0.314). There was no change of tooth stability in the control group and the experimental group. CONCLUSIONS: The method for fixation of oral tracheal intubation can be used as a routine method during intraoral surgery.