Lu Tingting,Sun Fei,Cai Weiwei,et al.Application of nasal intubation using self-shaping endotracheal tube under video laryngoscopy in pediatric daytime dental caries treatment[J].Journal of Clinical Pediatric Surgery,2025,(10):975-980.[doi:10.3760/cma.j.cn101785-202408016-013]
可视喉镜下经鼻自塑形气管插管在小儿日间口腔龋病治疗中的应用
- Title:
- Application of nasal intubation using self-shaping endotracheal tube under video laryngoscopy in pediatric daytime dental caries treatment
- Keywords:
- Self-shaping Reinforced Tube; Nasotracheal Intubation; Day-case General Anesthesia; Pediatric Dental Caries; Video Laryngoscopy
- 摘要:
- 目的 探讨可视喉镜下经鼻自塑形气管插管在小儿日间口腔手术中对于保障气道安全与便捷的应用价值。方法 本研究为前瞻性随机对照研究,选取2024年2月至2024年8月南京医科大学附属儿童医院口腔科择期行日间全身麻醉下龋病治疗的患儿120例作为研究对象,随机分为自塑形导管组(M组)和插管钳组(S组),每组60例。患儿均在可视喉镜引导下进行气管插管,M组使用自塑形导管,S组使用插管钳辅助导管。收集两组插管时间、初次插管成功率、并发症发生率(如鼻出血、咽部损伤等),并监测麻醉诱导后(T0 )、喉镜下暴露声门时(T1)以及气管插管后1 min(T2)、3 min(T3)的不同时间点HR、MAP、SpO2等生命体征变化。结果 两组均成功完成插管和手术。与S组比较,M组插管时间缩短[(20.8±3.3)s比(24.1±4.1)s],鼻咽部软组织损伤发生率降低(8.3%比30%),差异均有统计学意义(P<0.05),其中鼻出血的发生率分别为5.0%、16.6%。与T0时点比较,两组T2时点HR均增快、MAP均增加,差异有统计学意义(P<0.05)。M组与S组T2时点比较,HR、MAP均低于S组,差异有统计性意义(P<0.05)。但两组不同时点SpO2差异无统计学意义(P>0.05)。结论 自塑形导管在可视喉镜引导下行经鼻气管插管用于儿童日间全麻龋病治疗安全、可行,可减少并发症,并提高插管效率。
- Abstract:
- Objective To evaluate the value of nasotracheal intubation using a self-shaping endotracheal tube under video laryngoscopy in ensuring airway safety and procedural efficiency during pediatric day-case dental caries treatment. Methods A total of 120 pediatric patients undergoing elective day-case dental caries treatment under general anesthesia in the Department of Stomatology,Affiliated Children’s Hospital of Nanjing Medical University,from February 2024 to August 2024,were enrolled and randomly assigned to the self-shaping tube group (Group M) or the Magill forceps group (Group S),with 60 patients in each group.All patients underwent nasotracheal intubation under video laryngoscopic guidance.Group M used a self-shaping tube alone,while Group S used Magill forceps to assist with tube placement.The intubation time,first-attempt success rate,and complication rates (e.g.,nasal bleeding,pharyngeal injury) were recorded.Vital signs including heart rate (HR),mean arterial pressure (MAP),and oxygen saturation (SpO2) were monitored at various time points. Results Compared to Group S,Group M had a shorter intubation time (20.8±3.3 s vs.24.1±4.1 s) and a significantly lower incidence of nasopharyngeal soft tissue injury (8.3% vs.30.0%),both with statistically significant differences (P<0.05).Specifically,the incidence of nasal bleeding was 5.0% in Group M and 16.6% in Group S.Compared with the T0 time point, both groups showed significant increases in heart rate (HR) and mean arterial pressure (MAP) at T2, with statistically significant differences (P<0.05). At the T2 time point, the M group exhibited significantly lower HR and MAP values than the S group,and the differences were statistically significant (P<0.05). However,there were no statistically significant differences in SpO2 between the two groups at any time point (P>0.05). Conclusions Nasotracheal intubation with a self-shaping endotracheal tube under video laryngoscopy is a safe and feasible approach for pediatric dental caries treatment under general anesthesia in a day-case setting.It reduces complications and improves intubation efficiency.
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备注/Memo
收稿日期:2024-8-12。
通讯作者:钟治球,Email:zhongzhiqiu@163.com