GlideScope视频喉镜和Macintosh直接喉镜在颈椎制动患者气管插管中的比较  

Comparison of tracheal intubation using GlideScope and Macintosh laryngoscope in patients with cervical spine immobilization

作　　者：徐振东[1] 张军[1] 李琼[1] 李佩盈[1] 梁伟民[1] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海200040

出　　处：《复旦学报（医学版）》2009年第2期159-162,共4页Fudan University Journal of Medical Sciences

摘　　要：目的比较GlideScope视频喉镜和Macintosh直接喉镜在颈椎制动患者气管插管中的难易,及两种工具插管对血液动力学的影响。方法拟在经口气管插管全身麻醉下行择期手术的患者60例,ASAⅠ级,年龄18～60岁,随机分为G组和M组(n=30)。常规麻醉诱导后,手法制动头颈部,G组采用GlideScope视频喉镜,M组用Macintosh直接喉镜行气管插管。分析比较两组声门暴露情况(Cormark-Lehane分级)以及暴露时间,试插次数,失败例数,有无助手辅助,插管前后心率与收缩压乘积(rate-pressure product,RPP)变化。结果与M组比较,G组声门暴露情况较好,但暴露时间显著延长(P<0.05)。M组需要助手辅助及插管失败的比例均高于G组。两组RPP的变化在各个时点无显著差别。结论在为颈椎制动患者气管插管中,GlideScope视频喉镜能够更好的显露声门,降低插管难度,提高插管的成功率。Objective To compare the use of the GlideScope and the conventional Macintosh laryngoscope in simulated cervical spine immobilization. Methods Sixty patients,ASA I,between 18 and 60 years old, presenting for surgery requiring oro-tracbeal intubation, were randomly assigned to undergo intubation using Macintosh （group M, n = 30） or GlideScope （group G, n = 30）laryngoscope. Each patient was provided manual in-line axial stabilization of the head and neck by an experienced assistant. The following data were recorded and analyzed： Cormark-Lehane grade, glottic exposure time, total intubation attempts, manoeuvre needed to aid tracheal intubation, failure for tracheal intubation, and rate-pressure product （RPP） at the different time points of intubation process. Results Compared with group M, the laryngeal view was significantly better in group G, but the glottic exposure time of group G was longer （P^0. 05）. Fewer maneuvers were required in group G to improve the glottic exposure. GlideScope provided higher success rate of intubation when compared with Macintosh laryngoscope. There were no difference in RPP at all time points of intubation between groups. Conclusions The GlideScope might be a good alternative for tracheal intubation in patients with cervical spine immobilization by providing better view of glottic exposure and decreasing the diffculty of intubation.

关 键 词：颈椎制动 GLIDESCOPE视频喉镜 MACINTOSH直接喉镜 

分 类 号：R614.2[医药卫生—麻醉学]