纤维支气管镜用于直接喉镜暴露困难和模拟暴露困难患者的临床观察  

Clinical observation of Sensascope~ in real and simulated difficult tracheal intubation at direct laryngoscopy

作　　者：刘具会[1] 邓晓明[1] 隋静湖[1] 佟世义[1] 杨冬[1] 魏灵欣[1] 罗茂萍[1] 胥琨琳[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院麻醉科,北京100041

出　　处：《中国内镜杂志》2008年第4期418-420,423,共4页China Journal of Endoscopy

摘　　要：目的观察SensascopeR纤维镜引导插管用于直接喉镜暴露困难和模拟暴露困难患者的临床效果。方法40例行择期整形外科手术的气管插管全身麻醉患者,随机分为两组,每组20例。常规静脉快速诱导后,在Macintosh直接喉镜暴露Cormack-LehaneⅢ级的条件下用SensascopeR纤维镜分别在显像系统(S组)和目镜(E组)直视下气管插管。观察两组患者的插管时间、插管成功率、术后咽喉部疼痛的发生情况以及插管期间的血流动力学变化。结果两组患者全部顺利完成气管插管,其中S组的插管时间为(45.3±30.7)s,E组为(19.9±4.8)s,S组明显长于E组;两组的插管成功率差异无显著性。而咽痛发生率S组明显高于E组。插管期间患者血流动力学变化较小。结论SensascopeR纤维镜能够安全有效地应用于Macintosh直接喉镜暴露困难和模拟暴露困难患者的气管插管,是解决困难气管插管的一种新型插管工具。[Objective] To observe the clinical effects of a hybrid steerable semirigid S-shaped video styletSensascope in real and simulated difficult tracheal intubation due to poor glottis view at direct laryngoscopy. [Methods] Forty ASA Ⅰ-Ⅱ patients scheduled for elective plastic surgery under general anesthesia were randomly allocated into 2 groups （n = 20 for each）： screen group and eyepiece group. After rapid intravenous induction with midazolam 0.05 mg/kg, fentanyl 2 μg/kg, propofol 2 mg/kg and vecuronium 0.1 mg/kg, the patients in each group were orally intubated with Sensascope at real or simulated Cormack and Lehane Grade 3 view. In screen group, the Sensascope was connected to the video system, while in the eyepiece group, the operator performed via eyepiece. Circulatory responses during intubation, intubation time, success rate and incidence of pharyngalgia were recorded. [Results] All the patientswere intubated successfully. Mean intubation time in screen group was （ 45.3±30.7 ） s while in oyepiece group （19.9±4.8） s. There were no significant differences between these two groups in intubation success rate and incidence of pharyngalgia in screen group was more than that in eyepiece group. Circulatory responses were similar in these two groups during intubation. [Conclusion] Sensascope is a new device which can be safely used in real and simulated difficult tracheal intubation due to poor direct Macintosh laryngoscopic view.

关 键 词：纤维支气管镜 困难气管插管 血液动力学 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]