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全麻气管插管时,常因病人牙齿松动等因素而致牙齿脱落入口腔,现报道2例。例1,,男,58岁,行开颅肿瘤切除手术。在全麻诱导插管过程中,因患者全口牙齿稀疏、松动,喉镜窥视片碰落左上侧切牙,并落入口腔中。在插入导管后,立即寻找脱落牙齿,见在舌后部,急用血管钳夹取,但两次均未成功,最终牙齿滑脱入口咽深部,无法明视。用手指在口腔内反复探索,都未能寻到脱落的牙齿,经X线摄片,见到在相当于下颌骨喙突下方有一牙齿状阴影,提示脱落牙齿已进入鼻咽部。据此,用手指经口腔在鼻咽部摸到脱落牙齿,用长弯血管钳取出。
General anesthesia endotracheal intubation, often due to the patient's teeth and other factors caused tooth loss off the mouth, are reported in 2 cases. Example 1 ,, male, 58 years old, open craniotomy surgery. Induced intubation in general anesthesia process, due to patients with sparse teeth, loose, laryngoscope blade touched the left upper incisor, and fall into the mouth. Immediately after inserting the catheter, look for the tooth to fall off. See the back of the tongue. Use a forceps clamp to take it. However, neither of the two succeeded. The final tooth slipping deep into the entrance pharynx can not be clearly seen. Repeated exploration with your fingers in the mouth, have failed to find the tooth off, the X-ray film to see the equivalent of mandibular coracoid below a tooth-shaped shadow, suggesting that the teeth have fallen into the nasopharynx. Accordingly, with your fingers through the oral cavity in the nasopharynx touched the teeth off, with a long curved forceps removed.