摘要
目的 评定在插管困难病人中采用盲探气管插管装置 (BTII)实施光导食管引导插管的价值。方法 将 136例气管插管困难病例分为三组 :组 A(90例 ,清醒状态 )、组 B(16例 ,全麻状态 )分别为预知和未预知插管困难的病人 ,均由技术熟练者插管 ,组 C(30例 )为预知插管困难而由非熟练者插管的病人。全组均采用 BTII光导食管引导插管 ,并观察其临床应用情况。结果 组 A和组 B的插管成功率为 98.9%和 93.8% ,插管时间为 8.1min和 3.2 min。组 C中 2次操作成功发生率和插管时间明显多于由熟练者操作的组 A (P<0 .0 5 )。经鼻食管气管引导管的置管深度 b与鼻翼根部至耳屏中点的距离 a有十分显著的相关性 (r=0 .9118,P<0 .0 1) ,直线回归方程式为 b=11.85 + 1.0 2 2 a(cm)。结论 采用 BTII实施光导食管引导插管可用于多种插管困难病人 ,具有临床推广价值。
Objective To study clinical evaluation of oesophagus-light-guided tracheal intubation using blind tracheal intubation instrument(BTII) for patients with difficult intubation. Methods 136 cases with difficult tracheal intubation were devided into three groups: group A with 90 expected cases and group B with 16 unexpected cases were intubated by a skilled anesthesiologist(the training times of BTII intubation>=20), group C with 30 expected cases were operated by unskilled anesthesiologists(the training times of BTII intubation<=5). The scales of predication of expected difficult intubation werre distance of opening mouth less than 3cm, degree of cervical tilting back less than 30°, Mallampati III^IV degree, and distance between protuberances of thyroid cartilage and chin less than 6.5cm. The unexpected difficult intubations were those occurred after anesthetic induction with time of intubation by laryngoscope more than 10 minutes or attempts of intubation by laryngoscope more than 3. Group A and group C were done awake intubation. Group B were intubated under general anesthesia. All patients were done oesophagus-light-guided tracheal intubation by BTII. The results of clinical application were observed. Results The successful rates of group A and group B were 98.9% and 93.8%, respectively time of intubation was 8.1 minutes and 3.2 minutes. THe rate of two attempts to success and time of intubation in group C were more than that in group A( P <0.05). There was a significant correlation between the depth(b) of nasa oesophagus-tracheal introducer and the distance(a) from the root of alae nasi to the tragus of ear( r=0.9118,P< 0.01), and the linear regressive equation was b=11.85+1.022a(cm). Conclusion The method of oesophagus-light-guided tracheal intubation using BTII can be used in kinds of difficult intubation. It has clinical spread value.
出处
《口腔颌面外科杂志》
CAS
2000年第4期295-298,共4页
Journal of Oral and Maxillofacial Surgery
关键词
盲探气管插管装置
光导食管引导插管
气管插管困难
BTⅡ光导食管
Blind tracheal intubation instrument
Oesophagus-light-guided tracheal intubation
Difficult tracheal intubation@
