Rosen C L, Wolfe R E, Chew S E, Branney S W, Roe E J
Department of Emergency Medicine, Massachusetts General Hospital, Boston, USA.
J Emerg Med. 1997 Mar-Apr;15(2):141-5. doi: 10.1016/s0736-4679(96)00355-1.
Blind nasotracheal intubation (BNTI) is an effective procedure for the intubation of trauma patients. The presence of major facial trauma has been considered a relative contraindication due to the perceived risk of intracranial placement. The purpose of the present study was to assess the risk of intracranial placement in patients with facial fractures who undergo BNTI. The records of 311 patients with facial fractures were reviewed for methods of intubation and complications. Eighty-two patients underwent BNTI. There were no cases of intracranial placement, significant epistaxis requiring nasal packing, esophageal intubation, or osteomyelitis. Three patients (4%) developed sinusitis and eight (10%) developed aspiration pneumonia. We conclude that the presence of facial trauma does not appear to be a contraindication to BNTI.
盲探经鼻气管插管术（BNTI）是创伤患者插管的一种有效方法。由于存在颅内置入风险，严重面部创伤一直被视为相对禁忌证。本研究的目的是评估接受BNTI的面部骨折患者发生颅内置入的风险。回顾了311例面部骨折患者的插管方法和并发症记录。82例患者接受了BNTI。没有发生颅内置入、需要鼻腔填塞的严重鼻出血、食管插管或骨髓炎的病例。3例患者（4%）发生鼻窦炎，8例患者（10%）发生吸入性肺炎。我们得出结论，面部创伤似乎并非BNTI的禁忌证。
