自制下颌提升固定器辅助纤支镜经口气管插管的临床研究

目的在纤支镜经口气管插管中,比较自行设计的一种下颌提升固定器（Jaw elevation fixation device,JEFD）的安全性和有效性。方法选取100名ASA I～II级,年龄18～65岁的择期腹腔镜手术患者,随机分成C组和J组行纤支镜经口气管插管：C组辅用人工托下颌法,J组用下颌提升固定器法。采用静脉麻醉诱导,待患者意识丧失肌肉松弛后行纤支镜操作。观察并记录两组患者声门暴露时间、气管插管时间及成功率、调整托下颌手法/JEFD次数和出现颈前区红点的例数以及插管相关并发症。结果两组患者均获成功,未见明显并发症。声门暴露及插管时间两组差异无统计学意义（P〉0.05）。调整托下颌手法/JEFD的例数C组明显多于J组（P〈0.05）,而出现颈前区红点例数则明显少于J组（P〈0.05）。结论下颌提升固定器可有效并安全地取代麻醉医生在纤支镜操作中的人工托下颌法。

Fiberoptic bronchoscope with the aid of jaw elevation fixation device for oral tracheal intubation

Objective To investigate the efficacy and safety of homemade jaw elevation fixation device(JEFD) during the operation of fiberoptic bronchoscope for oral tracheal intubation.Methods 100 ASA I～II patients,aged 18 years or older,who scheduled for laparoscopic procedures requiring tracheal intubation were randomly assigned to C group using fiberoptic bronchoscope with assistant’s help of elevation of the jaw and J group using JEFD for oral tracheal intubation.After standard intravenous anesthetic induction,insertion of endotracheal tube was performed.The time of glottic exposure and trachea intubation,success rate,cases of adjusting elevation of jaw and red dot appeared in cervical area,and incidence of complications were recorded.Results All cases were successful.There were no obvious statistical significance in the time of glottic exposure,trachea intubation,success rate and the incidence of complications related to tracheal intubation between two goups,but cases of adjusting elevation of jaw in C group were more than those of J group,and cases of red dot appeared in cervical area were less than those of J group(P< 0.05).Conclusion JEFD can effectively and safely replace manual elevation of the jaw by other anesthesiologist during the operation of fiberoptic bronchoscope.