腹腔镜套管针在颧颌复合体骨折手术中应用颏下插管1例

Journal of Trauma and Injury Pub Date : 2023-06-01 Epub Date: 2022-12-21 DOI:10.20408/jti.2022.0036
Hyejin Do, Chunui Lee, Hyeon Don Hong, Hyejin Hong, Hyun Kyo Lim, Sujin Kim
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引用次数: 0

摘要

颏下插管是颌面部创伤患者气道管理的有效替代技术。与气管造口术相比,它的侵入性较小,但有潜在气道损害的风险,如气管阻塞、塌陷和扭结引起的缺氧。为了缩短手术时间和确保加强管腔,我们使用腹腔镜套管针作为一种新的装置进行颏下插管。一名54岁男性患者持续颧骨腋窝复合体骨折,计划接受切开复位和内固定。我们进行了口内插管,并在下颌中线处做了一个1厘米的小切口。从切口部位剥离组织后,使用12毫米腹腔镜套管针通过强化管。整个过程耗时约5分钟,从断开呼吸回路并通过套管针内腔到重新连接呼吸机的呼吸暂停时间为1分5秒。使用腹腔镜套管针进行颏下插管,可以缩短解剖时间,防止气管内软组织或血块导致腔隙闭塞并发症,减少软组织损伤
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Submental intubation using laparoscopic trocar in zygomaticomaxillary complex fracture surgery in Korea: a case report.

Submental intubation is an effective alternative technique for airway management in patients with maxillofacial trauma. Compared with tracheostomy, it is less invasive, but has risks associated with potential airway compromise such as hypoxia due to tube obstruction, collapse, and kinking. To shorten procedure time and ensure a reinforced tube lumen, we used a laparoscopic trocar as a new device for submental intubation. A 54-year-old male patient sustained a zygomaticomaxillary complex fracture and was scheduled to undergo open reduction and internal fixation. We performed intraoral intubation and made a small 1-cm incision at the submandibular midline. After dissection of the tissue from the incision site, a reinforced tube was passed using a 12-mm laparoscopic trocar. The procedure took about 5 minutes, and apnea time from disconnecting the breathing circuit and passing through the internal lumen of the trocar until it was reconnected to the ventilator was 1 minute 5 seconds. Using a laparoscopic trocar for submental intubation can reduce the time required for dissection, prevent luminal occlusion complications due to soft tissues or blood clots in the endotracheal tube, and decrease soft tissue damage.

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