肥胖患者应用Truview^(TM) EVO_2光学喉镜行气管插管的应用  

Clinical application of Truview^(TM) EVO_2 optic laryngoscope in anesthetic endotracheal intubation for fat patients

作　　者：李洪[1] 罗远国[1] 张旭[1] 曾军[1] 王东[1] 胡春林[1] 

机构地区：[1]解放军第181医院麻醉科,广西桂林541002

出　　处：《重庆医学》2008年第17期1913-1915,共3页Chongqing medicine

摘　　要：目的评价对肥胖并有插管困难的患者应用TruviewTM EVO2光学喉镜行气管插管的方法。方法经全身麻醉气管插管肥胖患者12例,入选标准为体质量指数大于或等于30,术前行气道评估,包括Mallampati评分,甲颏间距离和张口度。常规麻醉诱导经Macintosh直接喉镜无法完成气管插管的患者,气管插管困难明确后使用TruviewTM EVO2光学喉镜插管,记录诱导前、插管前、插管后的血流动力学变化,插管时间,喉部结构显露Cormack-Lehane分级,同时随访插管后咽痛等不良反应。结果插管后收缩压和心率均有增加。所有患者均一次插管成功,平均插管时间为62.3s(45~103s),12例患者中仅有1例两种喉镜Cormack-Lehane喉部结构显露分级相同,均为Ⅲ级,余11例TruviewTMEVO2光学喉镜Cormack-Lehane喉部显露分级优于Macintosh喉镜,2例患者气管导管进入声门较困难。除1例术后咽痛,其余无不良反应。结论TruviewTM EVO2光学喉镜对于肥胖并潜在插管困难患者是一种简便易行的插管装置。Objective To evaluate the clinical intubation of TruviewTM EVO2 optic laryngoscope in difficult airway of fat pa tients. Methods Twelve fat patients, ASA Ⅰ --Ⅱ scheduled under general anaesthesia requiring orotracheal intubation had the criteria of body mass index≥30. Preoperative airway including mouth opening, Mallampati score and thyromental distance was assessed. After induction,intubation was atemptted by using a Macintosh size 3 blade. All patients met the criteria of difficult intubation, then,Truview^TM EVO3 laryngoscope was used to expose the epiglotis and atempt to intubate the patient. The Cormack-Lehane grade was evaluated by the same anesthetist. Parameters were recorded,including haemodynamlc changes,intubating time and Cor mack-Lehane grade of laryngeal view. Postoperatively,sore throat or hoarseness were followed up for all patients. Results In eleven of twelve patients,TruviewTM EVO2 optic laryngoscope achieved better laryngeal view than Macintosh direct laryngoscope did and there was only one patient who get the same Cormack-Lehane grade of laryngeal view with two laryngoscopes,grade Ⅲ. After intu bation systolic pressure and heart rate increased compared with pre-intubation（P〈0.05）. All patients were successfully intubated in one attempt. Mean intubating time was 62.3s（45--103s）. The tracheal tube was difficult into glottis aperture in two cases,and all patients but one have no obvious sore throat postoperatively. Conclusion Truview^TM EVO2 optic laryngoscope appears to be a simple and effective technique for difficult airway in fat patients.

关 键 词：TRUVIEW^TM EVO2光学喉镜 气管插管 肥胖 困难气道 

分 类 号：R614[医药卫生—麻醉学]