各类经鼻气管插管方法及其相关并发症和应对措施的研究进展

Research progress of various nasotracheal intubation methods and related complications and countermeasures

经鼻气管插管与经口气管插管均是麻醉和重症监护下气道管理的基本方法。经鼻气管插管已经成为经口气管插管的有效替代方法,因为其不仅能为口腔颌面外科手术提供更好的视野,并且由于清醒患者较易耐受鼻导管,咽喉分泌物较少,能为创伤及危重患者带来更多的益处。随着临床经验的积累和器械的改进,经鼻气管插管方法也在不断改进,使经鼻气管插管更安全,并发症更少。现将经鼻气管插管常见方法及其优劣,相关并发症和应对措施的研究进展综述如下,以便在未来的临床活动中,根据患者的意识状态、呼吸道分泌物、病情严重程度、操作者经验、设备条件等综合判断分析,选择最佳的气管插管方式。

Both nasotracheal intubation and oral endotracheal intubation are basic methods for airway management under anesthesia and intensive care. Nasotracheal intubation has become an effective alternative method to oral endotracheal intubation, because it can not only provide a better vision for oral and maxillofacial surgery, but also bring more benefits to trauma and critical patients because conscious patients are more tolerant of nasal intubation and less throat secretions. With the accumulation of clinical experience and the improvement of instruments, the nasotracheal intubation method is also improving, making nasotracheal intubation safer and less complications. The research progress of common methods, advantages and disadvantages, related complications and countermeasures of nasotracheal intubation are summarized as follows, so that in the future clinical activities, the best endotracheal intubation method can be selected according to the comprehensive judgment and analysis of the patients’ state of consciousness, respiratory secretions, disease severity, operator experience and equipment conditions.