鼻肠管导引气管导管在非预测声门暴露困难患者插管中的应用

目的：探讨鼻肠管导引气管导管在声门暴露困难患者插管中应用的可行性。方法：把声门暴露困难型病例随机分两组：经口常规会厌后下方盲探插管组（A组，n=25）和经口鼻肠管导引气管导管插管组（B组，n=25）。分别进行盲探插管并记录统计插管次数、插管时间（从开始插管到听诊证实成功）、插管过程中追加麻药的次数及各时段的血压（BP）、心率（HR）、氧饱和度（SpO2）变化和插管并发症等。结果：B组插管1～2次的成功率明显高于A组（P〈0．05），BP、HR变化明显小于A组（P〈0．05），无1例发生低血氧症（SpO2〈95％）、呛咳或气管支气管痉挛等插管并发症。结论：鼻肠管导引导管用于非预测声门暴露困难患者气管内插管方法是一种简便、安全、有效的气管插管方法，值得推荐使用。

Study on feasibility of naso-intestinal tube guiding tracheal catheter for intubation in patients with non-predicated glottis exposing difficulty

Objective:To investigate the feasibility of naso-intestinal tube guiding the tracheal catheter for tracheal intubation in patients with non-predicated glottis exposing difficulty.Methods:Fifty patients with glottis exposing difficulty were randomly assigned into group A(n=25) and group B(n=25),patients in group A underwent intubation using conventional way by oral epiglottis blind exploring,and patients in group B underwent naso-intestinal tube guided intubation.Parameters associated intubations in the two groups were recorded and studied,including times of intubation,operative time of intubation(from starting to success of intubation proved by auscultation),administration of anesthetic agents,blood pressure(BP),heart rate(HR) and blood oxygen saturation(SpO2) in different phases,complications of intubation.Results:The intubation success rate of one or two times operation in group B was significantly higher than in group A(P<0.05);BP,HR changes in group B were significantly less than in group A(P <0.05);no complication such as low blood oxygen(SPO2<95%),cough or bronchospasm occurred.Conclusion:Guiding the tracheal catheter with naso-intestinal tube for the tracheal intubation in patients with non-predicated glottis exposing difficulty is simple,safe,effective and feasible