关键词: 3D打印, 困难气道, 气管插管, 气道评估

Abstract: Objective　To explore the application effect of 3D printing technology in assisting intubation for patients with difficult airway. Methods　Sixty patients who required orthopedic surgery under general anesthesia and had difficult airway at Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) from January 2020 to June 2023 were selected, and were divided into a 3D group (30 cases) and a control group (30 cases) according to the random number table method. In the 3D group, there were 27 males and 3 females, with an age of (36.28±10.42) years old and a body mass index of (22.90±1.27) kg/m², and the American Society of Anesthesiologists (ASA) classification was grade II in 18 cases and grade III in 12 cases. In the control group, there were 26 males and 4 females, with an age of (35.89±11.06) years old and a body mass index of (22.84±1.52) kg/m², and the ASA classification was grade II in 15 cases and grade III in 15 cases. The 3D group used 3D printing technology to create a model of difficult airway before surgery and simulated tracheal intubation on the model; the control group used a video laryngoscope or bronchoscope for tracheal intubation based on the assessment results of common surface difficult airway indicators. The intubation time and the number of successful first intubation cases were recorded, and the hemodynamic indexes, stress responses, and intubation-related complications during intubation were evaluated. Statistical analysis was conducted using t test, non-parametric test, and χ² test. Results　Both groups had successful extubation after surgery. The intubation time, the number of times of intubations, and the proportions of changing intubation tools and post-extubation pharyngeal discomfort in the 3D group were all lower than those in the control group, with statistically significant differences (all P<0.05). Compared with those before induction, both groups showed a decrease in the systolic blood pressure (SBP) and diastolic blood pressure (DBP) after induction, with statistically significant differences (all P<0.05); compared with those after induction, the SBP and DBP of both groups increased 5 minutes and 30 minutes after intubation, with statistically significant differences (all P<0.05). Compared with those before induction, the blood glucose and cortisol levels in both groups increased 5 minutes after intubation, with statistically significant differences (all P<0.05); the blood glucose and cortisol levels in the 3D group were lower than those in the control group 5 minutes after intubation, with statistically significant differences (both P<0.05). During the intubation process of both groups, no tooth damage occurred, but a small amount of blood was found on the laryngoscope blades of a few patients. The incidences of hypoxia during intubation, postoperative 24-hour sore throat, and transient hoarseness in the 3D group were lower than those in the control group [3.33% (1/30) vs. 20.00% (6/30), 13.33% (4/30) vs. 40.00% (12/30), 3.33% (1/30) vs. 20.00% (6/30)], with statistically significant differences (all P<0.05). Conclusion　The application of 3D printing technology in difficult airway can shorten the intubation time, improve the success rate, and reduce the intubation injury.

Key words: 3D printing technology, Difficult airway, Tracheal intubation, Airway assessment