单纯鼻腔表面麻醉在电子喉镜检查中的效果

Clinical effect of single nasal topical anesthesia in electronic laryngoscopy

摘要:

目的 比较单纯鼻腔表面麻醉和鼻腔加咽喉表面麻醉在电子喉镜检查过程中的患者舒适度、操作者完成检查难易程度及完成检查所需时间。方法 将1 300例患者随机归入单纯鼻腔表面麻醉组（A组）和鼻腔加咽喉表面麻醉组（B组），每组650例。比较两组患者内镜检查总体感受评分、医生内镜操作总体感受评分及完成检查所需时间。分别从两组中选取初步诊断为咽喉恶性肿瘤的患者11例（A’组）和13例（B’组），比较两组患者内镜检查总体感受评分、医生内镜操作总体感受评分及完成检查所需时间。结果 两组完成检查所需时间比较（A组与B组比较，A’组和B’组比较），差异均无统计学意义；A组患者内镜检查总体感受评分高于B组；A组医生内镜操作总体感受评分高于B组；A’组患者内镜检查总体感受评分与B’组比较，差异无统计学意义；A’组医生内镜操作总体感受评分与B’组比较，差异无统计学意义。结论 在常规电子喉镜检查过程中，单纯鼻腔表面麻醉优于鼻腔加咽喉表面麻醉，不能配合者再追加咽喉表面麻醉；在难度较大的电子喉镜检查过程中，鼻腔加咽喉表面麻醉效果并不优于单纯鼻腔表面麻醉，尚需寻找更好的麻醉方法。

Abstract:

Objective To compare the patients comfort and physicians difficulty and the procedure time during transnasal fiberoptic laryngoscopy after single nasal topical anesthesia or naso-oro topical anesthesia.Methods This study included 1 300 patients randomizely divided into group A (single nasal topical anesthesia, n = 650) and group B (naso-oro topical anesthesia, n = 650). Feeling scores (0～10) was used to evaluate patient tolerance and procedure success by the operator, independently. Procedure time was also recorded. Then, we made a subgroup analysis according to the preliminary diagnosis of laryngeal malignant tumor.Results There was no significant difference in the examination time between the two groups. Both patients’ and doctors’ scores were significantly higher in group A. There was no significant difference in feeling scores between the two groups. There was no significant difference in procedure time between the two groups.Conclusion Single nasal topical anesthesia seems to be superior to naso-oro topical anesthesia in patients undergoing uncomplicated laryngoscopy, if the patient can't endure the procedure, additional naso-oro topical anesthesia should be given then. Naso-oro topical anesthesia seems to be not superior to single nasal topical anesthesia in patients underwent complicated laryngoscopy, doctors should try to find better anesthesia methods.