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目的探讨保留呼吸慢诱导经鼻盲探插管在颌面外科手术困难气管插管中的应用效果。方法选择ASAⅠ～Ⅱ级择期行颌面外科手术的患者47例,术前预测评估为困难气道,年龄11～60岁,采用保留呼吸慢诱导方法经鼻盲探气管插管,观察记录插管次数和血流动力学变化。结果47例中30例一次性插管成功,9例经改变头位,旋转导管方向后试插3次进入气管内,8例能置入喉镜者经口明视下将导管插入气管,插管过程中血流动力学稳定,术后患者对插管过程无记忆,未见与插管有关的并发症。结论保留呼吸慢诱导经鼻盲探气管插管用于颌面外科困难气管插管病人,在插管期间患者处于浅睡眠状态,保留自主呼吸,从而解决快速诱导后发生插管困难以及应用肌松药后气道阻塞的危险后果,而且心血管不良反应小,术后无记忆,插管成功率高,是一种安全有效、并发症少的麻醉方法。
Objective To investigate the effect of slow-breathing nasal blind catheterization on tracheal intubation in maxillofacial surgery. Methods Forty-seven patients undergoing selective maxillofacial surgery under ASA Ⅰ-Ⅱ were enrolled in this study. The preoperative evaluation was difficult airway, ranging in age from 11 to 60 years. Nasal blind tracheal intubation was performed by the method of slow- Frequency and hemodynamic changes. Results Of the 47 cases, 30 cases were successful in one-time intubation, 9 cases were changed head position, the catheter was rotated 3 times into the trachea, and 8 cases could be placed into the laryngoscope. Hemodynamically stable during the procedure, postoperative patients no memory of the intubation process, no complications associated with intubation. CONCLUSION: Nasal blind tracheal intubation is used to induce slow nasal blind tracheal intubation in patients with maxillofacial surgery. During the intubation, the patient is in a shallow sleep state and spontaneous respiration is maintained, so as to solve the difficulty of intubation after rapid induction and the application of muscle relaxant The dangerous consequence of airway obstruction after medicine, and the small adverse cardiovascular reaction, no memory after operation, high success rate of intubation, is a safe and effective method with less complications.