加强型与普通型气管导管在纤维支气管镜经鼻气管插管中的对比

目的在纤维支气管镜辅助经鼻气管插管中比较加强型气管导管(Reinforced Endotracheal Tube,RETT)与普通型气管导管(Endotracheal Tube,ETT)的差异。方法 60例急诊硬膜外或硬膜下血肿需行血肿清除术的全麻患者随机分成两组:RETT组用加强型气管导管行气管插管,ETT组用普通型气管导管。采用静脉麻醉诱导,待患者意识丧失肌肉松弛后插入气管导管。观察并记录一次成功率、插管时间、插管前后血流动力学指标的变化幅度、鼻咽黏膜损伤出血例数及程度。结果 RETT组插管时间明显短于ETT组(P<0.05),而一次成功率明显高于ETT组(P<0.05)。插管前后血流动力学指标的变化幅度两组差异无统计学意义(P>0.05)。出血例数ETT组多于RETT组(P<0.05),而出血程度两组分布构成分布差异有统计学意义(P<0.05)。结论纤维支气管镜检辅助经鼻气管插管,选用加强型气管导管较普通型气管导管可明显缩短插管时间,提高一次成功率,同时减少鼻咽部出血的发生率及降低出血程度。

Comparative study on the effect of reinforced endotracheal tube and endotracheal tube in nasotracheal intubation guided by fiberoptic bronchoscope

Objective To compare the effect of endotracheal tube (ETT) and reinforced ETT (RETT) in nasotracheal intubation guided by fiberoptic bronchoscope. Methods Sixty patients with emergency epidural or subdural hematoma scheduled for hematoma evacuation were randomly divided into two groups: RETT group (using RETT for endotracheal intubation), ETT group (using a common type of ETT for endotracheal intubation). After intravenous anesthetic induction, insertion of endotracheal tube was performed. The first success rate, the time of trachea intubation, the magnitude of changes in hemodynamic parameters before and after intubation, and the cases and degrees nasopharyngeal bleeding were observed and recorded. Results The intubation time was significantly shorter in RETT group than ETT group (P<0.05). The first success rate was significantly higher in RETT group than ETT group (P<0.05). The magnitude of changes in hemodynamic parameters before and after intubation showed no statistically significant differences between the two groups (P>0.05). The cases of bleeding in ETT group were more than that in RETT group (P<0.05), and the degree of bleeding showed statistically significant difference between the two groups (P<0.05). Conclusion In nasotracheal intubation guided by fiberoptic bronchoscope, the use of RETT can significantly shorten the intubation time, and improve the first success rate, as well as reduce the incidence and the degree of nasopharyngeal bleeding.