颈部延伸体位对经鼻气管插管时导管通过鼻腔/口咽交界处的影响

Effect of neck extension position on the successful passage of tracheal tube through the nasal/oropharyngeal junction

目的探讨颈部延伸体位对经鼻气管插管时气管导管顺利通过鼻腔/口咽交界处的影响。方法选择行耳鼻喉和口腔科手术的患者80例,随机分为颈部延伸体位组(Y组)和中立位组(N组)。比较两组患者的气管插管通过口咽部成功率、气管插管通过口咽部一次成功率、鼻出血发生率和分级、气管导管通过口咽部的时间、总气管插管时间和气管导管通过鼻腔通路。结果Y组患者气管插管通过口咽部的成功率和一次成功率均高于N组,差异均有统计学意义(χ^(2)分别=10.91、6.36,P均<0.05)。Y组患者气管插管从鼻腔进入口咽部的时间短于N组,差异有统计学意义(t=2.41,P<0.05)。两组患者总插管时间、鼻出血发生率、鼻出血严重程度和气管导管途经的鼻腔通路(上通道/下通道)比较,差异均无统计学意义(t=0.63,χ^(2)分别=0.08、0.98,P均>0.05)。结论经鼻气管插管过程中,颈部延伸体位有利于气管导管从鼻腔顺利推进到口咽部,并且不影响插管时间。

Objective To investigate the effect of neck extension position on the successful passage of the tracheal tube through the nasal/oropharyngeal junction.Methods A total of 80 patients who underwent otolaryngology and oral surgery were selected and randomly divided into the neck extension position group(Y group)and neutral position group(N group).The success rate of endo tracheal intubation through the oropharynx,the one-time success rate of endotracheal intubation through the oropharynx,the incidence and grade of epistaxis,the time for the tracheal tube to pass through the oropharynx,the total tracheal intubation time,and the passage of the tracheal tube through the nasal cavity were com-pared between the two groups.Results The success rate and the one-time success rate of endotracheal intubation through oropharynx in Y group were higher than those in N group(χ^(2)=10.91,6.36,P<0.05).The time of endotracheal intubation from nasal cavity to oropharynx in Y group was shorter than that in N group(t=2.41,P<0.05).There were no significant differences in total intubation time,incidence of epistaxis,severity of epistaxis and nasal passage(upper/lower passage)between two groups(t=0.63,χ^(2)=0.08,0.98,P>0.05).Conclusion In the process of nasal endotracheal intubation,the neck extension position is beneficial to the smooth advancement of the endotracheal tube from the nasal cavity to the oropharynx,and does not affect the intubation time.