Abstract:

Objective　To compare the difficulty and complications of nasal tracheal intubation guided by visual laryngoscope between supersmooth coated tracheal catheter and ordinary reinforced catheter. Methods　This study was a randomized controlled trial. A total of 120 patients were prospectively selected from Shenzhen University General Hospital from June 2023 to August 2023 for elective surgery under general anesthesia through nasal tracheal intubation, including patients in stomatology and spinal orthopedics, with American Society of Anesthesiologists (ASA) grade Ⅰ to Ⅲ, aged 18 to 65 years, regardless of gender. The patients were divided into two groups by the random number table method: a supersmooth coated tracheal catheter group (group C) and an ordinary reinforced tracheal catheter group (group P), with 60 cases in each group. The time of catheter passing through the nasal cavity, catheter tip bloodstain score (B₁), cuff bloodstain score (B₂), and total injury score (B=B₁+B₂) were recorded. The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO₂) were recorded before intubation (t₁), after the catheter passing through the nasal cavity (t₂), and 1 min after passing through the glottis (t₃). t test, analysis of variance for repeated measurements, and χ² test were used. Results　During the process of nasal tracheal intubation, the time of catheter passing through the nasal cavity [(8.43±4.85) s] in group C was shorter than that in group P [(17.00±8.91) s], with a statistically significant difference (P<0.05). The incidence of catheter tip bloodstain in group C [9.4% (5/53)] was lower than that in group P [27.6% (16/58)], with a statistically significant difference (P<0.05). Comparison of HR at 3 time points in group P showed statistically significant differences (all P<0.05). Conclusion　Supersmooth coated tracheal catheter is a safe and effective tool for nasal tracheal intubation, which can shorten the time of catheter passing through the nasal cavity, reduce the damage of the catheter tip to the nasal cavity, and is beneficial for the stability of hemodynamics.

Key words:

Nasal tracheal intubation, Supersmooth coated tracheal catheter, Ordinary reinforced catheter, Clinical efficacy

摘要：

目的　比较超滑涂层气管导管、普通加强导管在可视喉镜引导下经鼻气管插管的难易程度与并发症。方法　本研究为随机对照试验，前瞻性选择深圳大学总医院2023年6月至2023年8月拟行经鼻气管插管全身麻醉下择期手术的患者120例，包括口腔科、脊柱骨科等手术患者。美国麻醉医师协会（ASA）分级Ⅰ～Ⅲ级，年龄18～65岁，性别不限。患者采用随机数字表法分为两组：超滑涂层气管导管组（C组）和普通加强气管导管组（P组），每组60例。记录导管经过鼻腔的时间、插管时导管尖端染血评分（B₁）、套囊染血评分（B₂）及损伤总分（B=B₁+B₂），同时记录插管前（t₁）、导管过鼻后腔（t₂）及过声门后1 min（t₃）的平均动脉压（MAP）、心率（HR）及脉搏血氧饱和度（SpO₂）。采用t检验、重复测量的方差分析和χ²检验。结果　在经鼻气管插管过程中，C组导管经过鼻腔的时间［（8.43±4.85）s］比P组［（17.00±8.91）s］更短，差异有统计学意义（P<0.05）；C组导管尖端染血发生率［9.4%（5/53）］较P组［27.6%（16/58）］更低，差异有统计学意义（P<0.05）；P组患者3个时间点的HR比较，差异均有统计学意义（均P<0.05）。结论　超滑涂层气管导管在经鼻插管时能缩短导管经鼻时间，减轻导管尖端对鼻腔损伤，同时有利于患者血流动力学平稳，是一种安全有效的经鼻气管插管工具。

关键词:

经鼻气管插管, 超滑涂层气管导管, 普通加强导管, 临床效果