可视喉镜下不同鼻孔入路对鼻插管的影响

目的 在可视喉镜下观察经不同鼻孔入路对鼻插管的影响。方法 采用随机数字表法将120例美国麻醉医师协会(ASA)分级Ⅰ级的颌面手术患者随机分为A组(左鼻孔入路)和B组(右鼻孔入路),每组60例。麻醉快速诱导后,采用Tosight视频喉镜完成经鼻插管,记录并比较两组导管一次通过鼻腔率、导管通过鼻腔时间、声门暴露时间、插管总时间、插管成功率和鼻腔出血情况。结果 A、B两组患者在导管入鼻一次成功率(84.7%比81.7%;χ ² =0.202,P=0.653)、导管通过鼻腔时间(7.3±4.6)s比(7.5±4.1)s;t=-0.223,P=0.824]、声门暴露时间(6.6±1.4)s比(6.7±1.4)s;t=-0.348,P=0.728] 和插管总时间(35.1±9.2)s比(34.0±7.8)s;t=0.663,P=0.509]方面差异均无统计学意义。两组的置管一次成功率均为100%。A组有16例(27.1%)发生插管相关鼻出血,B组有17例(28.3%),差异也无统计学意义(χ ² =0.022,P=0.882)。结论 经不同鼻孔入路对鼻插管影响无差别。

Impacts of Different Nostril for Nasotracheal Intubation with Video Laryngoscopy

Objective To compare the impacts of different nostril on nasotracheal intubation with video laryngoscopy.Methods Totally 120 ASA grade I maxillofacial surgery patients were equally randomized into two groups:group A(left nostril)and group B(right nostril).After rapid induction of anesthesia,the nasal intubation was completed by Tosight video laryngoscope,and the success rate of the first attempt of the tube passing through the nasal cavity was recorded and compared between these two groups.In addition,time of tube through nasal cavity,time of glottis exposure,total intubation time,intubation success rate,and nasal bleeding were recorded.Results The success rate of the first attempt of tube passing through the nasal cavity was not significantly different between groups A and B(84.7% vs. 81.7%;χ ²=0.202,P=0.653).The time of tube passing through nasal cavity (7.3±4.6)s vs.(7.5±4.1)s;t=-0.223,P=0.824] and the time of glottic exposure (6.6±1.4)s vs.(6.7±1.4)s;t=-0.348,P=0.728] had no significant differences between two groups.The success rates of first intubation attempt were 100% in both groups.The total intubation time was(35.1±9.2)s in group A and(34.0±7.8)s in group B(t=0.663,P=0.509).Intubation-related epistaxis was found in 16 cases(27.1%)in group A and in 17 cases(28.3%)in group B(χ ² =0.022,P=0.882).Conclusion Different nasal approaches have no effect on nasal intubation.