目的

比较传统喉镜、普通胃镜、鼻胃镜等三种辅助气管插管方法的效果。

方法

将2023 年1 月至2023 年12 月经解放军第九六〇医院拟行无痛内镜手术全身麻醉的气管插管 114 例患者纳入本研究，随机分为三组，传统喉镜组 36 例采用常规喉镜辅助气管插管、普通胃镜组 45 例采取普通胃镜辅助气管插管，鼻胃镜辅助组 33 例采取鼻胃镜辅助气管插管。 比较三组患者插管成功率、气管插管所需时间、血流动力学及并发症发生情况。

结果

普通胃镜组及鼻胃镜辅助组患者一次性插管成功率为97.8%、100%，χ²=8.040，P=0.018，高于传统喉镜组插管成功率的86.1%，插管时间较传统喉镜组均明显缩短［（51.16±8.21）、（41.24±4.65）和（60.69±5.41）s，F=75.862，P＜0.001］；三组患者在麻醉诱导前、气管插管前、气管插管后 5 min 的各时间点血流动力学指标（HR、MAP、SpO₂）相比较，差异均无统计学意义（P＞0.05）。 在插管相关并发症方面，三组患者的口干、黏膜出血、声音嘶哑、拔管时套囊带血发生率均无明显差异（P＞0.05），但传统喉镜组患者发生呛咳例数及并发症总例数（7 例、17 例），较普通胃镜组（3 例、8 例）及鼻胃镜辅助组（1 例、4 例）高，差异有统计学意义（χ²=6.363，P=0.041；χ²=14.267，P＜0.001）。

结论

普通胃镜及鼻胃镜在一定范围内提高了插管成功率，缩短了全麻气管插管时间，减少了气管插管相关并发症，值得在内镜中心借鉴和推广。

Objective

To evaluate the differences between the three types of guided endotracheal intubation techniques：traditional laryngoscope，conventional gastroscope and nasal gastroscope.

Methods

The patients with tracheal intubation who underwent general anaesthesia for painless endoscopic surgery at The 960th Hospital of the PLA between January 2024 and December 2024 were enrolled.Patients were randomised into three groups.The conventional laryngoscope group （n=36） was treated with conventional laryngoscope-assisted tracheal intubation，the ordinary gastroscope group （n=45） was treated with ordinary gastroscope-assisted tracheal intubation，and the nasal gastroscope group （n=33） was treated with nasal gastroscope-assisted tracheal intubation.

Results

The success rate of one-time intubation in the conventional gastroscopy group and the nasal gastroscopy group was higher than that in the traditional laryngoscope group （97.8%，100% and 86.1%，χ² = 5. 426，P=0.046），and the intubation time was There was no significant difference in hemodynamic indexes （HR，MAP，SpO₂）among the three groups before anesthesia induction，before tracheal intubation and 5 min after tracheal intubation（P ＞0.05）.In terms of intubation-related complications，there was no significant difference in the incidence of dry mouth，mucosal bleeding，hoarseness，and bloody cuff during extubation among the three groups （P ＞ 0.05）.However，the number of patients with cough and the total number of complications in the traditional laryngoscope group （7 cases，17 cases） were higher than those in the conventional gastroscopy group（3 cases，8 cases） and the nasal gastroscopy group （1 case，4 cases），and the difference was statistically significant（χ²=6.363，P=0.041；χ²=14.267，P＜0.001）.

Conclusion

conventional gastroscopy and nasal gastroscopy improve the success rate of intubation within a certain range，shorten the time of tracheal intubation under general anesthesia，and reduce the complications related to tracheal intubation.It is worth promoting in the endoscopy center.