Mizuno Ju, Morita Shigeho, Suzuki Maya, Arita Hideko, Hanaoka Kazuo
Department of Anesthesiology, Teikyo University School of Medicine, Tokyo 173-8605.
Masui. 2010 Apr;59(4):432-9.
In tracheal intubation assisted by tube-guiding devices passing through the tube, such as fiberoptic scopes, bougies, tracheal tube exchange catheters, and light wands, passage of the tube-guiding device, by itself, is often easy. But advancing a tracheal tube with a conventional distal tip over these tube-guiding devices is frequently difficult or impossible, because its rigid, side-beveled tip frequently catches on anatomical features of the airway. A novel tracheal tube, the Parker Flex-Tip tube (Parker Medical, Colorado, USA) has a centered, curved, tapered and flexible distal tip that passes through the airway faster and easier than conventional tracheal tubes. As it is advanced along a tube-guiding device, the tip of the Parker tube travels along the midline of the airway, without the gap that usually exists between the distal edge of a conventional tracheal tube and the tube-guiding device. The gapless, midline travel of the Parker tube leads to a greater incidence of first-attempt intubation success with tube-guiding devices, because there is less risk of tube tip hang-ups on the arytenoids and the vocal cords. Clinically, use of the Parker tube is helpful for oral and nasal intubations, especially in patients with difficult airways.
在通过诸如纤维支气管镜、探条、气管导管交换导管和光棒等穿过气管导管的引导装置辅助进行气管插管时，引导装置本身的通过通常很容易。但是，使用传统远端尖端的气管导管沿着这些引导装置推进往往很困难甚至不可能，因为其刚性的侧斜面尖端经常会卡在气道的解剖结构上。一种新型气管导管，即帕克柔性尖端导管（美国科罗拉多州帕克医疗公司生产），具有居中、弯曲、渐缩且灵活的远端尖端，比传统气管导管更快、更轻松地穿过气道。当它沿着引导装置推进时，帕克导管尖端沿着气道中线行进，不存在传统气管导管远端边缘与引导装置之间通常存在的间隙。帕克导管无间隙的中线行进导致使用引导装置首次尝试插管成功的发生率更高，因为导管尖端挂在杓状软骨和声带上的风险更小。临床上，帕克导管的使用有助于经口和经鼻插管，尤其是在气道困难的患者中。
