在文献中,与视频喉镜检查相关的患者受伤的报道越来越多。关于设备的安全使用和消化道损伤后的患者护理有各种各样的意见。近年来,我们机构的视频喉镜检查相关伤害有所增加。正因为如此,我们希望确定与直接喉镜检查相比,视频辅助喉镜检查是否存在更大的损伤风险.此外,我们希望确定是否有患者和/或手术因素导致患者在视频喉镜检查后受伤.
MAMC麻醉记录,PubMed,奥维德.
我们通过搜索麻醉记录来确定导致软腭或口咽损伤的喉镜检查程序,比较了我们机构的视频喉镜检查与直接喉镜检查之间的损伤率。我们还在文献中发现了19个已发表的病例,除了我们的案子,我们审查了患者特征(例如,身体质量指数,年龄和性别,Mallampati等级),视频喉镜的类型,受伤的位置,以及所需的维修类型(如果有)。
在我们的机构,与直接喉镜检查相比,我们使用视频喉镜检查的损伤率在统计学上较高。我们的数据还表明,在电视喉镜插管期间,女性比男性更容易受伤。右侧扁桃体支柱和软腭是最常受伤的,软组织穿孔是最常见的损伤类型。最常见的损伤修复需要简单的闭合,长期伤害非常罕见。
我们的数据表明,与直接喉镜相比,使用视频辅助喉镜插管会使患者受伤的风险明显更大。喉镜,2016年127:349-353,2017.
Reports of patient injuries associated with videolaryngoscopy are increasing in the literature. There are a wide variety of opinions regarding both safe use of the device and patient care following aerodigestive tract injury. We have seen an increase in videolaryngoscopy-associated injuries in recent years at our institution. Because of this, we wanted to determine if video-assisted laryngoscopy presents a greater risk of injury compared with direct laryngoscopy. Furthermore, we wanted to determine if there were patient and/or surgical factors that could contribute to patient injuries following videolaryngoscopy.
MAMC anesthesia records, PubMed, Ovid.
We compared rates of injury between videolaryngoscopy to direct laryngoscopy at our institution by searching anesthesia records to identify laryngoscopy procedures that resulted in injury to the soft palate or oropharynx. We also identified 19 published cases in the literature, in addition to our cases, that we reviewed for patient characteristics (e.g., body mass index, age and sex, Mallampati grade), type of videolaryngoscope, location of injury, and type of repair (if any) required.
At our institution, we have a statistically higher rate of injury using videolaryngoscopy compared to direct laryngoscopy. Our data also indicate that women are more commonly injured during videolaryngoscope intubation than men. The right tonsillar pillars and soft palate are the most frequently injured, with through-and-through perforation of the soft tissues being the most common type of injury. The most common repair of injuries required simple closures, and long-term harm was very rare.
Our data suggests that using video-assisted laryngoscopy for intubation puts a patient at significantly greater risk for injury compared to direct laryngoscopy. Laryngoscope, 2016 127:349-353, 2017.