山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (1): 106-110.doi: 10.6040/j.issn.1673-3770.0.2021.056

• • 上一篇    下一篇

可视喉镜在先天性舌根囊肿患儿手术麻醉中的应用

赵海涛1, 王亚芳2, 赫莉2, 陈文静1, 邢民者1, 郑文娟2,阎玉彦2,刘晓峰2   

  1. 1. 河北省儿童医院 麻醉科, 河北 石家庄 050031;
    2. 河北省儿童医院 耳鼻咽喉科, 河北 石家庄 050031
  • 发布日期:2022-02-22
  • 通讯作者: 王亚芳. E-mail:wangyafang11@163.com

Application of visual laryngoscope in surgical anesthesia of children with congenital tongue base cyst

ZHAO Haitao1, WANG Yafang2, HE LI2, CHEN Wenjing1, XING Minzhe1, ZHENG Wenjuan2, YAN Yuyan2, LIU Xiaofeng2   

  1. 1. Department of Anesthesiology, Hebei Children's Hospital, Shijiazhuang 050031, Hebei, China;
    2. Department of Otorhinolaryngology, Hebei Children's Hospital, Shijiazhuang 050031, Hebei, China
  • Published:2022-02-22

摘要: 目的 探讨可视喉镜与传统喉镜在先天性舌根囊肿患儿麻醉气管插管中的临床效果和安全性。 方法 选择拟于气管插管全麻下行舌根囊肿切除术的患儿(Ⅰ~Ⅱ度呼吸困难)72例,随机分为传统喉镜组(M组)与可视喉镜组(G组)。记录两组患儿气管插管时间、一次插管成功率、插管失败率、声门显露程度、插管前与插管时SpO2、HR及MAP的变化及气道损伤等情况。 结果 G组气管插管时间短于M组,一次插管成功率高于M组,插管失败率及气道损伤均低于M组(P<0.05);G组声门显露显著优于M组(P<0.05)。插管时HR与MAP明显升高(P<0.05),其中M组升高更明显(P<0.05)。 结论 对于先天性舌根囊肿造成Ⅰ~Ⅱ度呼吸困难者,应用可视喉镜可以缩短插管时间,改善声门显露等级,提高一次插管成功率,最大限度的保证了患儿的安全,值得临床推广使用。

关键词: 可视喉镜, 气管插管, 舌根囊肿, 儿童

Abstract: Objective To explore the clinical effect and safety of visual laryngoscope and traditional laryngoscope in tracheal intubation in children with congenital tongue base cyst. Methods Seventy-two children(dyspnea grade I-II)scheduled for resection of tongue base cyst were randomly divided into two groups: traditional laryngoscope group(group M)and visual laryngoscope group(group G). The intubation time, success rate of intubation, failure rate of intubation, glottic exposure and airway injury were recorded. The saturation of pulse oxygen(SpO2), heart rate(HR)and mean arterial pressure(MAP)before and during intubation were observed. Results The tracheal intubation time of group G was shorter than that of group M, the success rate of one-time intubation was higher than that of group M, the intubation failure rate and airway injury of group G were lower than those of group M(P<0.05); HR and MAP increased significantly during intubation, especially in group M. Conclusion For children with Ⅰ-Ⅱ mild dyspnea caused by congenital tongue base cyst,the application of video laryngoscope in endotracheal intubation can shorten the time of endotracheal intubation, improve glottic exposure level, improve the success rate of one-time intubation, and ensure the safety of children to the greatest extent. It was worthy of clinical application.

Key words: Visual laryngoscope, Tracheal intubation, Tongue base cyst, Child

中图分类号: 

  • R767
[1] 朱增辉, 孟洋, 赵怀志, 等. 低温等离子射频消融术治疗先天性舌根囊肿一例[J]. 中华耳鼻咽喉头颈外科杂志, 2015,50(9): 775-776. doi:10.3760/cma.j.issn.1673-0860.2015.09.016.
[2] Eom M, Kim YS. Asphyxiating death due to basal lingual cyst(thyroglossal duct cyst)in two-month-old infant is potentially aggravated after central catheterization with forced positional changes[J]. Am J Forensic Med Pathol, 2008, 29(3): 251-254. doi:10.1097/PAF.0b013e31817efb0a.
[3] 郑铁华, 尹泓. 新生儿先天性会厌囊肿切除术麻醉管理二例[J]. 临床麻醉学杂志, 2013, 29(12): 1238.
[4] 于金辉, 王艳. SMT-Ⅱ可视喉镜在急诊困难气道经口插管的临床研究[J]. 中华外科杂志, 2017, 55(7): 549-553. doi:10.3760/cma.j.issn.0529-5815.2017.07.014. YU Jinhui, WANG Yan. Clinical study of SMT-Ⅱvideo laryngoscope with difficult airway intubation in emergency department[J]. Chinese Journal of Surgery, 2017, 55(7): 549-553. doi:10.3760/cma.j.issn.0529-5815.2017.07.014.
[5] 黄选兆,汪吉宝,孔维佳. 实用耳鼻咽喉头颈外科学[M]. 2版. 北京: 人民卫生出版社, 2007:446-448.
[6] 王桂香, 张杰, 赵靖, 等. 婴幼儿舌根囊肿的诊断及围手术期治疗要点[J]. 山东大学耳鼻喉眼学报, 2015, 29(3): 62-64. doi:10.6040/j.issn.1673-3770.0.2015.004. WANG Guixiang, ZHANG Jie, ZHAO Jing, et al. Diagnosis and perioperative treatment of tongue base cyst in infants[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2015, 29(3): 62-64. doi:10.6040/j.issn.1673-3770.0.2015.004.
[7] Kayhan FT, Yigider AP, Koc AK, et al. Treatment of tongue base masses in children by transoral robotic surgery[J]. Eur Arch Otorhinolaryngol, 2017, 274(9): 3457-3463. doi:10.1007/s00405-017-4646-0.
[8] 郭宇峰, 高兴强. 低温等离子射频消融术治疗新生儿先天性舌根囊肿的临床疗效[J]. 中国耳鼻咽喉头颈外科, 2017, 24(12): 644-646. doi:10.16066/j.1672-7002.2017.12.011. GUO Yufeng, GAO Xingqiang. Clinical efficacy of low-temperature radiofrequency ablaion for the treatment of neonatal tongue base cyst[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(12): 644-646. doi:10.16066/j.1672-7002.2017.12.011.
[9] 王春, 金泉英. 小儿先天性舌根囊肿切除术的麻醉处理五例[J]. 临床麻醉学杂志, 2013,29(3): 310.
[10] 赵海涛, 石磊, 刘晓江, 等. 婴儿先天性舌根囊肿的麻醉处理[J]. 河北医药, 2013, 35(9): 1370-1371. doi:10.3969/j.issn.1002-7386.2013.09.049.
[11] 于布为, 吴新民, 左明章, 等. 困难气道管理指南[J]. 临床麻醉学杂志, 2013, 29(1): 93-98.
[12] Vivek B, Sripriya R, Mishra G, et al. Comparison of success of tracheal intubation using Macintosh laryngoscope-assisted Bonfils fiberscope and Truview video laryngoscope in simulated difficult airway[J]. J Anaesthesiol Clin Pharmacol, 2017, 33(1): 107-111. doi:10.4103/0970-9185.202198.
[13] 刘亚洋, 薛富善, 李慧娴, 等. 视频喉镜在患儿气道管理中的应用进展[J]. 临床麻醉学杂志, 2018, 34(6): 609-612. doi:10.12089/jca.2018.06.021.
[14] 梁开远, 黄光梅, 李泽均, 等. UE可视喉镜在急诊剖宫产患儿床边气管插管术中的应用[J]. 临床麻醉学杂志, 2020, 36(6): 559-562. doi:10.12089/jca.2020.06.009. LIANG Kaiyuan, HUANG Guangmei, LI Zejun, et al. Application of UE glidescope in the bedside endotracheal intubation of children during emergency Caesarean section[J]. Journal of Clinical Anesthesiology, 2020, 36(6): 559-562. doi:10.12089/jca.2020.06.009.
[15] 王俊林, 黄洪强, 施晓华, 等. HC可视喉镜在新生儿唇裂手术的应用[J]. 临床麻醉学杂志, 2014, 30(8): 785-787. WANG Junlin, HUANG Hongqiang, SHI Xiaohua, et al. The clinical application of HC video laryngoscope intubation in the neonate with a cleftlip[J]. Journal of Clinical Anesthesiology, 2014, 30(8): 785-787.
[16] 何伟, 黄梦朦, 刘铁帅, 等. HC视频喉镜与macintosh直接喉镜引导患儿气管插管术效果的比较[J]. 中华麻醉学杂志, 2014(11): 1357-1360. doi:10.3760/cma.j.issn.0254-1416.2014.11.020. HE Wei, HUANG Mengmeng, LIU Tieshuai, et al. Comparison of HC video-laryngoscope and Macintosh direct laryngoscope for tracheal intubation in pediatric patients[J]. Chinese Journal of Anesthesiology, 2014(11): 1357-1360. doi:10.3760/cma.j.issn.0254-1416.2014.11.020.
[17] 韩传宝, 周钦海, 刘存明, 等. 纤维支气管镜在困难气管插管中的应用[J]. 临床麻醉学杂志, 2014, 30(1): 90-92. HAN Chuanbao, ZHOU Qinhai, LIU Cunming, et al. Journal of Clinical Anesthesiology[J]. Journal of Clinical Anesthesiology, 2014, 30(1): 90-92.
[18] 陈卓毅, 林创兴. 纤维支气管镜在新生儿困难气管插管中的应用[J]. 中国内镜杂志, 2016, 22(5): 97-98. doi:10.3969/j.issn.1007-1989.2016.05.021. CHEN Zhuoyi, LIN Chuangxing. Fiber bronchoscopy in neonatal difficult tracheal intubation[J]. China Journal of Endoscopy, 2016, 22(5): 97-98. doi:10.3969/j.issn.1007-1989.2016.05.021.
[1] 杨扬,王晓旭,张杰. 儿童中耳胆脂瘤诊治进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 1-6.
[2] 高信忠,林宗通,沈翎,刘平凡,林兴,许杨杨. 咽鼓管球囊扩张联合腺样体切除术治疗儿童分泌性中耳炎疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 7-12.
[3] 马宁,陈敏,刘薇,杨扬,邵剑波,郝津生,刘冰,张晓,段晓岷,张祺丰,张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[4] 胡春燕,党攀红,张睿,樊孟耘. 儿童单侧感音性听力损失的听力学及影像学特征149例分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 31-36.
[5] 党攀红,张睿,胡春燕,王洁,樊孟耘. 儿童乳突-颞下迷路外面神经减压术8例临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 37-42.
[6] 刘珊珊, 韩书婧, 王晓旭, 李艳红, 倪鑫, 张杰. 儿童细菌性脑膜炎后听力损害危险因素的系统评价与Meta分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 48-54.
[7] 焦雪梅,杨扬,李春凤,张晓琳. 鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 60-63.
[8] 王蓬鹏,葛文彤,唐力行,杨小健,张薇,肖潇,韩阳. 开放性鼻整形切口治疗儿童先天性鼻中线囊肿及瘘管4例及文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 64-69.
[9] 李孟辉,郅莉莉,戚凯文,王珊珊,高倩,步美玲,姜荷云,冯绛楠,王金荣. 皮下免疫治疗对单一尘螨和合并霉菌过敏儿童哮喘的临床研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 75-80.
[10] 黄桂亮,孙昌志,罗仁忠,陈彦球,刘少锋,许家健. 内镜在婴幼儿舌根囊肿手术中的临床应用分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 100-105.
[11] 师晓丽, 牟鸿. 多学科联合诊治重度儿童阻塞性睡眠呼吸暂停综合征并发肺动脉高压1例[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 116-119.
[12] 赵兴贺,樊明月,窦训武,贾广彪. 儿童原发扁桃体弥漫大B细胞淋巴瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 120-124.
[13] 龙婷,刘雨薇,王生才,张杰,李艳珍,张雪溪,刘悄吟,刘志勇,孙念,倪鑫. 内镜CO2激光烧灼术治疗273例儿童先天性梨状窝瘘的临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 125-130.
[14] 袁晨阳,刘燕综述房振胜审校. 儿童阻塞性睡眠呼吸暂停低通气综合征对肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 143-148.
[15] 刘艺,于明坤,孙伟,邵震,胡媛媛,毕宏生. 角膜塑形术控制儿童近视有效性与安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 92-100.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!