标题：输尿管软镜引导经鼻困难气管插管的临床应用

      作者：卢增停，何绮桃，杨纲华，王立勋，曾丽蓉，马钧阳，林霭婷
    (南方医科大学附属小榄医院麻醉科，广东 中山 528415)

      卷次： 2014年25卷6期

      【摘要】 目的 观察输尿管软镜引导经鼻困难气管插管的临床效果。方法 42例困难气管插管患者采用输
尿管软镜引导经鼻气管插管。记录患者麻醉诱导前、插管前、插管后即刻、插管后5 min的MAP、HR、SpO2；记录
插管成功率、插管时间(自插管操作至成功)、并发症情况(呛咳、喉痉挛、躁动、呼吸抑制、SpO2<90%、心律失常等)；
术后随访患者口咽及气道等插管相关损伤情况。结果 插管一次成功率为90.5%，二次成功率为100%，完成插
管时间1~8 min，平均4.2 min。插管过程中SpO2维持在91%~100%，血流动力学维持在正常范围，未出现激烈呛
咳、喉痉挛、躁动、呼吸抑制等并发症，术后随访无声嘶、明显咽部不适和插管相关损伤。结论 输尿管软镜引导
经鼻困难气管插管安全可行，简捷有效，值得在基层医院临床工作中应用。

      【关键词】 输尿管软镜；插管法；气管内；困难气道

      【中图分类号】 R653 【文献标识码】 A 【文章编号】 1003—6350（2014）06—0825—03


Clinical application of transnasal tracheal intubation with difficult airway guided by flexible ureteroscope.
LU
Zeng-ting, HE Qi-tao, YANG Gang-hua, WANG Li-xun, ZENG Li-rong, MA Jun-yang, LIN Ai-ting. Department of
Anesthesiology, Xiaolan Hospital Affiliated to Southern Medical University, Zhongshan 528415, Guangdong, CHINA

【Abstract】 Objective To observe the clinical effect of transnasal tracheal intubation with difficult airway
guided by flexible ureteroscope. Methods Transnasal tracheal intubation was performed with flexible ureteroscope
in 42 patients with difficult airway. Mean arterial pressure (MAP), heart rate (HR) and SpO2 were recorded at 4 time
points: before induction of anesthesia, just befote intubation, just after intubation and 5 minutes after intubation. The
success rate of intubation, intubation time (since the intubation operation to succeed) and the complications (cough, la-
ryngeal spasm, agitation, respiratory depression, SpO2<90%, arrhythmia, etc.) were observed. Postoperative follow-up
of patients were recorded with oropharyngeal and airway intubation injury. Results The one-time success rate of in-
tubation was 90.5%, and the two-time success rate was 100%. The intubation time was 1~8 minutes and the average
time of intubation was about 4.2 minutes. SpO2 in the intubation process was maintained at 91%~100%, hemodynam-
ics remained in the normal range. There were no complications such as fierce cough, laryngeal spasm, agitation and re-
spiratory depression. Postoperative follow-up of patients were found with no hoarseness, obvious pharyngeal discom-
fort and catheter related injury. Conclusion Transnasal tracheal intubation with difficult airway guided by flexible
ureteroscope is safe and feasible, simple and effective, which could be widely used in basic hospitals.