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在接受选择性手术的儿科患者中进行的视频鼻镜和直接鼻镜的比较评估

Tuncer Yavuz¹, Lütfiye Pirbudak¹, Elzem Şen¹

¹Gaziantep University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Gaziantep, Türkiye.

Turkish journal of anaesthesiology and reanimation

|July 22, 2025

概括

视频喉腔镜 (VL) 在儿童中提供了更好的喉视图,但需要更长的时间,并且在第一次尝试中成功率低于直接喉腔镜 (DL). VL对于儿科呼吸道的困难是有用的.

科学领域:

麻醉学麻醉学
儿科重症监护儿科重症监护

背景情况:

儿科呼吸道管理由于与成人的解剖和生理差异存在独特的挑战.
视频喉腔镜 (VL) 是一种比直接喉腔镜 (DL) 更先进的方法,用于气管输管.

研究的目的:

在接受选择性手术的儿科患者中,比较VL与DL在气管管道输管方面的疗效和安全性.

主要方法:

一项前性随机研究涉及100名儿科患者 (ASA I-III,年龄<18岁,体重10-40公斤).
患者被随机分为两个组:DL (n=50) 和VL (n=50).
收集的数据包括输管时间,喉视图 (Cormack-Lehane等级),第一次尝试成功率,需要前喉压力和并发症.

主要成果:

静脉脉表现出改善的喉视觉 (科马克-莱汉等级1:78%对66%) 和减少对前喉压力的需要 (32%对78%,P=0.01).
然而,VL与更长的输管时间 (29.1±5.7s vs. 20.7±5.1s,P=0.001) 和较低的第一次尝试成功率 (74% vs. 98%,P <0.001) 相关.
在这两组中都没有注意到创伤或低氧化等重大并发症.

结论:

视频鼻镜可增强喉视觉,并减少儿童患者需要呼吸道操纵的需要.
直接喉腔镜在例行儿科输管术中仍然更有效.
VL对于预期或出现的难以解决的儿科呼吸道情景是一个有价值的工具.

关键词:

航道管理是指空中航道管理.直接喉镜检查是指直接的喉镜检查.选择性外科手术是一种选择性手术.儿科内输管术 (Pediatric Intubation) 是指儿童的内输管术.视频鼻喉镜视频鼻镜.

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