GlideScope~视频喉镜在麻醉气管插管中的应用  

Application of GlideScope~ in anesthetic endotracheal intubation

作　　者：丁希喆[1] 王祥瑞[1] 

机构地区：[1]上海交通大学医学院仁济医院麻醉科,上海200127

出　　处：《上海交通大学学报（医学版）》2007年第2期206-208,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的　评价GlideScope　视频喉镜在静吸复合麻醉气管插管中的应用价值。方法200例ASA分级为Ⅰ或Ⅱ级、接受外科手术并施行静吸复合麻醉的患者，其中运用GlideScope视频喉镜（GS组）和3号 Macintosh直接喉镜（ML组）进行气管插管各100例。分析比较两组患者麻醉插管不同时间点无创血压（NBP）和心率（HR）、声门暴露时间、Cormark-Lehane分级、插管次数和插管时间。结果　与GS组比较，ML组声门暴露时患者NBP和HR的增加程度较为显著（P〈0．01），且恢复速度较慢。两组的声门暴露时间无明显差异。GS组插管时间明显长于ML组（P=0．001），其声门暴露较好（P=0．001）。结论　在静吸复合麻醉气管插管过程中，与普通Macintosh直接喉镜相比，GlideScope视频喉镜能提高声门暴露的程度，操作时患者心血管反应较小；但不能缩短声门暴露时间和插管时间。Objective To evaluate the clinical application of GlideScope video laryngoscope in anesthetic endotracheal intubation. Methods Two hundred patients who received surgery under general anesthesia with ASA I or II were involved in this study. One hundred patients were assigned to be intubated with GlideScope （GS group） and the other 100 with size 3 Macintosh laryngoscope （ML group）. The following data were recorded and analyzed： noninvasive blood pressure （NBP）, heart rate （HR） at the different time points of intubation process, glottic exposure time, Cormark-Lehane grade, tracheal intubation time and total intubation attempts. Results The rise of NBP and HR in ML group were significantly higher than those in GS group （ P 〈0.01 ）, and the duration of NBP to recover to post-induction level in ML was longer. There was no significant difference of the glottic exposure time between the two groups, but the intubation time in GS was significantly longer than that in ML （ P = 0. 001 ）. GS achieved better glottic exposure view（ P = 0. 001 ）. Conclusion GS laryngoscopy, compared with ML in the anesthetic endotracheal intubation, can yield comparably better glottic exposure view and induce less hemodynamic responses during laryngoscopy and tracheal intubation, but the total intubation time of GS is longer than ML.

关 键 词：气管插管 GLIDESCOPE 视频喉镜 MACINTOSH直接喉镜 心血管反应 

分 类 号：R614[医药卫生—麻醉学]