气道管理设备的应用特点(英文)  

The application characteristics of airway management devices

作　　者：丁希喆[1] 王祥瑞[1] 

机构地区：[1]上海交通大学医学院附属仁济医院麻醉科,上海市200001

出　　处：《中国组织工程研究与临床康复》2007年第5期987-989,993,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:总结几类气道管理设备:喉罩通气、食道气道双腔导管、纤维光学导丝喉镜、视频Mac喉镜气管插管系统以及GlideScope9视频喉镜的优缺点以及应用前景。资料来源:检索Medline 1990-01/2006-02与气道管理设备相关的文献,检索词“airway management”,限定文献语言种类为英文。资料选择:对资料进行初审,选择与应用喉罩通气、食道气道双腔导管、纤维光学导丝喉镜、视频Mac喉镜气管插管系统以及GlideScopeK视频喉镜进行气管插管研究插管成功率、插管相关并发症发生率有关的文献。纳入标准:①对成年病例的随机对照研究。②临床研究实验或者病例报告。③包括对一般气道或者困难气道的研究。排除标准:①对儿童插管的研究。②重复性研究。数据提炼:共收集到有关喉罩通气、食道气道双腔导管、纤维光学导丝喉镜、视频Mac喉镜气管插管系统以及GlideScopeK视频喉镜的文章86篇,36篇符合纳入标准,排除的50篇为对儿童插管研究或重复性研究。资料综合:正确的喉罩置入不会影响声带功能,患者戴喉罩时可以发声。其成功率在90%以上。其优点在于无论麻醉师的经验是否足够均可以快速而又容易的置入喉罩,降低咳嗽发生的频率和置入后的咽喉炎发生率。食道气道双腔导管可获得有效通气,其在急救情况下的应用十分成功。缺点是只有成人型号。纤维光学导丝喉镜的灵活性使其在应用时不需要调整患者头部和颈部的位置,主要缺点是视野有限及高昂的购买和维护费用。视频Mac喉镜气管插管系统的观察和操作可在一个轴上完成。GlideScopeK视频喉镜可以在屏幕上提供一个更为清晰的喉视野,插管可以根据图像指示进行调整,而不是只凭操作者的肉眼所见进行调整。结论:这些新型的气道管理设备都在不同程度上降低了插管难度,提高了插管成功率,相对减少了插管相关并�OBJECTIVE： To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway （LMA）, esophageal-tracheal combitubes （ETC）, fribreoptic stylet laryngoscope （FOS）, video Macintosh intubating laryngoscope system （VMS） and GlideScope videolaryngoscope（GSVL）. DATA SOURCES ： Using the terms ＂airway management＂, we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English. STUDY SELECTION ： The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive criteria： （1） Randomized and controlled study of adult cases. （2） Clinical studies or case report. （3） Including the studies of general airway or difficult airway. Exclusive criteria： （1） Study of intubation in children. （2） Repetitive study. DATA EXTRACTION： Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study. DATA SYNTHESIS ： Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combltube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadv

关 键 词：呼吸道管理 困难气道 插管 喉罩 喉镜 

分 类 号：R318[医药卫生—生物医学工程]