在口腔光纤引导插管过程中，半坐姿对下颌推力获得的气道间隙的影响
Effect of Semi-sitting Position on Airway Clearance Obtained by Jaw Thrust During Oral Fiberoptic-Guided Intubation.
摘要(中文译文)
在麻醉患者中，经口气管插管时纤维支气管镜引导下插管可能具有挑战性，原因是咽部肌肉张力丧失，导致舌、软腭和会厌向后移位。托下颌等手法可改善气道通畅性，但其有效性可能因患者体位而异。半坐位已被证明可减少上气道塌陷。本研究比较了经口纤维支气管镜引导插管过程中，半坐位与仰卧位下托下颌所获得的气道 clearance。这项前瞻性随机对照研究纳入年龄18-60岁、美国麻醉医师协会（ASA）I-II级、接受择期手术并需经口气管插管的成年患者。患者随机分为两组：25°半坐位加托下颌（SS组）和仰卧位加托下颌（S组）。评估软腭水平气道 clearance（主要结局）及会厌水平气道 clearance、声带和隆突可视时间、导管推进所需尝试次数、总插管时间以及拔管后气道创伤。统计分析采用卡方检验和Student t检验，p<0.05认为有统计学意义。共60例患者完成研究（每组30例）。半坐位组软腭水平气道 clearance 显著更优（p<0.001）。两组会厌水平 clearance 相当（p=0.100）。半坐位组声带可视时间（12.35±6.68 vs. 15.99±5.37 s；p=0.024）和隆突可视时间（19.92±7.10 vs. 25.05±7.03 s；p=0.007）显著更短。导管推进尝试次数、导管通过时间、总插管时间以及创伤或术后咽痛发生率在各组间相似。未发生插管失败或血氧饱和度下降。25°半坐位下托下颌可在经口纤维支气管镜引导插管过程中提供更优的软腭水平气道 clearance，并使声带和隆突可视更快。总插管时间和导管推进特征在不同体位间保持相似。因此，半坐位可能是一种有用的辅助措施，可改善麻醉患者咽部通畅性并促进纤维支气管镜引导插管。
Abstract
Oral fiberoptic-guided intubation can be challenging in anesthetized patients due to loss of pharyngeal muscle tone, resulting in posterior displacement of the tongue, soft palate, and epiglottis. Maneuvers such as jaw thrust can improve patency, but their effectiveness may vary with patient position. Semi-sitting positioning has been shown to reduce upper airway collapsibility. This study compared airway clearance obtained by jaw thrust in the semi-sitting versus supine position during oral fiberoptic intubation. This prospective randomized comparative study included adult American Society of Anesthesiologists (ASA) I-II patients aged 18-60 years undergoing elective surgery with orotracheal intubation. Patients were randomized into two groups: semi-sitting at 25° with jaw thrust (Group SS) and supine with jaw thrust (Group S). Airway clearance at the soft palate level (primary outcome) and at the epiglottis, time to visualize the vocal cords and carina, attempts required for tube advancement, total intubation time, and post-extubation airway trauma were assessed. Statistical analysis used chi-square and Student's t-test, with p<0.05 considered significant. Sixty patients completed the study (30 per group). Airway clearance at the soft palate was significantly better in the semi-sitting group (p<0.001). Clearance at the epiglottis was comparable between groups (p=0.100). Time to visualize the vocal cords (12.35±6.68 vs. 15.99±5.37 s; p=0.024) and carina (19.92±7.10 vs. 25.05±7.03 s; p=0.007) was significantly shorter in the semi-sitting group. Tube advancement attempts, time for tube passage, total intubation time, and incidence of trauma or postoperative sore throat were similar across groups. No intubation failures or desaturation occurred. Jaw thrust in the 25° semi-sitting position provides superior airway clearance at the soft palate and allows faster visualization of the vocal cords and carina during oral fiberoptic intubation. Overall intubation time and tube advancement characteristics remain similar between positions. Semi-sitting positioning may therefore be a useful adjunct to improve pharyngeal patency and facilitate fiberoptic-guided intubation in anesthetized patients.
如何引用
AMA
Kumar Saurabh, Yasana Shami. Effect of Semi-sitting Position on Airway Clearance Obtained by Jaw Thrust During Oral Fiberoptic-Guided Intubation.. Cureus. 2026; doi:10.7759/cureus.109464.
APA
Kumar Saurabh, Yasana Shami (2026). Effect of Semi-sitting Position on Airway Clearance Obtained by Jaw Thrust During Oral Fiberoptic-Guided Intubation.. Cureus. https://doi.org/10.7759/cureus.109464
GB/T 7714
Kumar Saurabh, Yasana Shami. Effect of Semi-sitting Position on Airway Clearance Obtained by Jaw Thrust During Oral Fiberoptic-Guided Intubation.[J]. Cureus, 2026 doi:10.7759/cureus.109464.
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