[1]翟文雯李岩王宁**.颏下气管插管在复杂颌面骨折患者中的应用：附12例报告[J].中国微创外科杂志,2026,01(3):0.
　Zhai Wenwen,Li Yan,Wang Ning..Application of Submental Tracheal Intubation in Complex Maxillofacial Fractures: Report of 12 Cases[J].Chinese Journal of Minimally Invasive Surgery,2026,01(3):0.
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颏下气管插管在复杂颌面骨折患者中的应用：附12例报告()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年3期
页码:
0
栏目:
短篇论著
出版日期:
2026-03-26

文章信息/Info

Title:
Application of Submental Tracheal Intubation in Complex Maxillofacial Fractures: Report of 12 Cases
作者:
翟文雯李岩王宁**
(北京大学第三医院麻醉科，北京100191)
Author(s):
Zhai Wenwen;  Li Yan;  Wang Ning.
Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China
关键词:
颌面创伤; 颏下气管插管; 气道管理
Keywords:
Maxillofacial trauma; Submental tracheal intubation; Airway management
文献标志码:
A
摘要:
目的探讨颏下气管插管用于复杂颌面骨折患者气道管理的安全性。方法回顾性分析我院2024年1月~2025年8月12例复杂颌面骨折行颏下气管插管的临床资料，插管由麻醉医生与颌面外科医生协作完成，经颏下旁正中线切口建立口底通道，将经口插入的气管导管引出并固定，术毕再将导管回纳口腔后经口拔除。结果12例均成功实施颏下气管插管，插管操作时间(8.2±1.8)min。呼吸回路断开时间均不超过1 min，断开前基线呼气末二氧化碳分压(pressure of endtidal CO２，PETCO2)(37.4±1.6)mm Hg,重连后PETCO2(37.6±1.4)mm Hg，无明显数值波动。2例术后转入重症监护室(合并肋骨骨折、肺挫伤预计早期拔管困难，均于术后48 h内拔除气管导管)；其余10例术后拔管时间(9.1±5.4)min，术后麻醉后恢复室(postanesthesia care unit，PACU)时间(315±18.5)min，出PACU时Aldrete评分均≥9分。术后住院期间无切口感染、血肿、涎瘘、舌神经感觉异常及唾液腺功能异常。术后1个月门诊复查所有患者无增生性瘢痕形成，无主诉舌神经感觉异常或唾液渗漏。结论颏下气管插管是颌面创伤患者安全、有效、微创的气道管理技术，美容效果良好，可作为颌面创伤患者气管切开术的替代方案。
Abstract:
ObjectiveTo investigate the safety of submental tracheal intubation for airway management in patients with complex maxillofacial fractures.MethodsClinical data of 12 patients with complex maxillofacial fractures who underwent submental tracheal intubation in our hospital from January 2024 to August 2025 were retrospectively analyzed. Submental intubation was performed collaboratively by anesthesiologists and maxillofacial surgeons. A paramedian submental incision was made to create a passage through the floor of the mouth, through which the orally inserted tracheal tube was externalized and fixed. After surgery, the tube was returned to the oral cavity and removed via the oral route.ResultsSubmental tracheal intubation was successfully performed in all the 12 cases, with a mean operation time of (8.2±1.8) min. The duration of respiratory circuit disconnection was less than 1 min in all the patients. The baseline pressure of endtidal CO2 (PETCO2) was (37.4±1.6) mm Hg before disconnection and (37.6±1.4) mm Hg after reconnection, with no significant fluctuation observed. Two patients were transferred to the ICU postoperatively (predicted to have difficulty in early extubation for rib fractures and pulmonary contusion) and tracheal tubes were removed within 48 h after surgery. The remaining 10 patients had an extubation time of (9.1±5.4) min, a postanesthesia care unit (PACU) stay of (31.5±18.5) min, and the Aldrete scores ≥ 9 points at PACU discharge. No severe complications such as wound infection, hematoma, salivary fistula, lingual nerve paresthesia, or salivary gland dysfunction were observed during the postoperative hospital stay. At 1month outpatient followup, no hypertrophic scar formation, subjective lingual nerve paresthesia, or salivary leakage was reported in any patient.ConclusionsSubmental tracheal intubation is a safe, effective and minimally invasive airway management technique for patients with maxillofacial trauma, with favorable cosmetic outcomes. It can be used as an alternative to tracheostomy in patients with maxillofacial trauma.

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备注/Memo

备注/Memo:
基金项目：国家临床重点专科建设项目（2025年）**通讯作者，Email：745792508@qq.com
更新日期/Last Update: 2026-03-26