ERCP术中应用超细胃镜辅助气管插管与 标准气管插管麻醉的比较

Comparison of Anesthesia for Tracheal Intubation Assisted by Ultrafine Gastroscope and Standard Tracheal Intubation during ERCP

摘要: 目的：比较分析在内镜逆行胰胆管造影(Endoscopic Retrograde Cholangiopancreatography, ERCP)中应用超细胃镜辅助气管插管麻醉的价值。方法：选取2024年1月至9月我院内镜中心完成的39例使用超细胃镜辅助气管插管全麻进行ERCP的患者，纳入观察组；同时纳入32例在标准气管插管麻醉下进行ERCP的患者作为对照组。对比分析两组患者的人口统计学特征、手术适应症、术前准备时间、麻醉时间、手术时间及总房间时间。术前准备时间定义为从麻醉诱导开始至气管插管完成再到内镜进入口腔的时间。结果：与标准气管插管相比，接受超细胃镜辅助气管插管的患者术前准备时间的中位数显著减少(180秒vs 360秒，P < 0.001)，总房间时间的中位数也有所缩短(88分钟vs 90分钟，P < 0.05)。麻醉时间和手术时间的中位数及四分位数均低于对照组，但两组的时间分布差异未达到统计学意义。在术后并发症方面，观察组出现一例迟发性出血，而对照组则出现一例术后胰腺炎(post-ERCP pancreatitis, PEP)。结论：在ERCP过程中，相较于标准气管插管全麻，使用超细胃镜辅助气管插管能够显著缩短术前准备时间及总手术时间。

Abstract: Objective: To compare and analyze the value of anesthesia assisted by ultrafine gastroscope during endoscopic retrograde cholangiopancreatography (ERCP). Methods: Thirty-nine patients who underwent ERCP with anesthesia assisted by ultrafine gastroscope from January to September 2024 were selected as the observation group; meanwhile, thirty-two patients who underwent ERCP under standard tracheal intubation anesthesia were included as the control group. Demographic characteristics, surgical indications, preoperative preparation time, anesthesia time, operation time, and total room time were compared between the two groups. Preoperative preparation time was defined as the time from the start of anesthesia induction to the completion of tracheal intubation and the entry of the endoscope into the oral cavity. Results: Compared with standard tracheal intubation, the median preoperative preparation time was significantly reduced in patients receiving ultrafine gastroscope-assisted tracheal intubation (180 seconds vs 360 seconds, P < 0.001), and the median total room time was also shortened (88 minutes vs 90 minutes, P < 0.05). The median and quartiles of anesthesia time and operation time were lower than those of the control group, but the time distribution differences between the two groups did not reach statistical significance. In terms of postoperative complications, one case of delayed bleeding occurred in the observation group, while one case of post-ERCP pancreatitis (PEP) occurred in the control group. Conclusion: During ERCP, compared with standard tracheal intubation anesthesia, the use of ultrafine gastroscope-assisted tracheal intubation can significantly shorten the preoperative preparation time and total operation time.