目的：经口纤维支气管镜引导下气管插管是一项可行的管理困难气道的方法。操作者时常因寻找声门困难而插管受阻是目前该技术存在的问题。本研究旨在探讨联合舌牵引对于伴有困难气道的患者经纤维支气管镜引导下气管插管的效果。方法选择40例伴有困难气道需行择期手术的成年患者，随机分为两组，对照组及实验组（=20）。实验组患者行舌牵引下纤支镜气管插管，对照组患者仅单独行纤支镜气管插管。观察记录首次尝试插管成功率、总插管成功率及术后1d咽喉疼痛发生率。结果与对照组比较，实验组的总插管成功率更高，首次尝试插管成功的可能性更大。实验组患者术后1d咽喉疼痛发生率与对照组比较差异无统计学意义。结论本研究证实对伴有困难气道的患者舌牵引辅助下经纤维支气管镜引导气管插管是一项非常实用、有效的手段。%Objective To determine the effect of incorporating lingual traction on the success rate of fiberoptic bronchoscope- guided intubation in patients with anticipated difficult airways. Methods In this prospective rando-mized cohort study, 40 adult patients with anticipated difficult airways were enrolled and scheduled for elective surgery. They underwent fiberoptic bronchoscope-guided orotracheal intubation alone (contrast group, =20) or with lingual traction by an individual anesthesiologist (experimental group, = 20) after induction of general anesthesia and neuromuscular blockade. The primary endpoint was the successful rate of the first attempt intubation. The secon-dary outcome was overall successful rate of tracheal intubation. Finally the sore throat grade was observed on the 1st post-operative day. Results Fiberoptic intubation with lingual traction compared to fiberoptic intubation alone result-ed in a higher successful rate and greater odds for successful first attempt intubation. The overall successful rate of tracheal intubation in the experimental group was higher than that of the contrast group. Sore throat incidence on the post-operative day 1 was not significantly different between two groups. Conclusions In this study, lingual traction is shown to be a valuable maneuver for facilitating fiberoptic bronchoscope-guided intubation in the management of patients with anticipated difficult airways.
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