颈椎手术患者采用Glide scope视频喉镜辅助纤维支气管镜引导经鼻气管插管临床研究  

Efficacy of Fiberoptic Bronchoscope-guided Nasotracheal Intubation with Glidescope in Patients Undergoing Cervical Spine Surgery

作　　者：何荷番[1] 刘炜烽[1] 翁培清[1] 陈志远[1] 李岩[1] 

机构地区：[1]福建医科大学附属第二医院麻醉科,泉州362000

出　　处：《福建医科大学学报》2011年第3期221-224,共4页Journal of Fujian Medical University

摘　　要：目的评价颈椎手术患者Glide scope视频喉镜辅助纤维支气管镜（FOB）引导经鼻气管插管的效果。方法收集因择期颈椎手术而行全麻气管插管的患者40例,男性29例,女性11例,年龄（44.4±10.1）岁（18-58岁）,体质量48-79 kg,身高158-176 cm,ASAⅠ-Ⅱ级,Mallampatis分级Ⅰ或Ⅱ级。随机均分为2组,即Glide scope视频喉镜辅助FOB引导经鼻气管插管组（G组）和FOB直接引导经鼻气管插管组（F组）。麻醉诱导后,行经鼻气管插管。记录G组Glide scope视频喉镜声门及会厌的暴露情况,记录2组气管插管时间、气管插管期间的血压和心率以及术后咽喉部不良反应的发生情况等,并行统计学处理。结果 2组插管成功率均为100%;与F组比较,G组气管插管时间明显缩短,Glide scope视频喉镜暴露声门或部分声门14例（70%）,暴露会厌或部分会厌6例（30%）;2组血流动力学变化各时间点差别无统计学意义。结论颈椎手术患者采用Glide scope视频喉镜辅助FOB引导经鼻气管插管可明显缩短气管插管时间,且不增加心血管系统的应激反应。Objective To evaluate the efficacy of fiberoptic bronchoscope（FOB）-guided.Nasotracheal intubation with Glidescope in patients undergoing cervical spine surgery.Methods Forty ASA Ⅰ or Ⅱ patients,aged 18～58 a,weighing 48～79 kg,scheduled for cervical spine surgery under general anesthesia,were randomly divided into two groups（n=20）： FOB-guide nasotracheal intubation with glidescope（group G）,and FOB-guided nasotracheal intubation（group F）.Anesthesia was induced with mindazolam 0.04 mg/kg,fentany 3～4 μg/kg,propofol 2 mg/kg,cis-atracuriun 0.2 mg/kg.The intubation time,arterial blood pressure,heart rate（HR） at the different time points of intubations process were recorded in two groups.All the patients were followed up postoperatively for adverse effects like sore throat or hoarseness,etc.The number of golttic exposure,epiglottic exposure with Glidescope were recorded in group G.Results The intubation time was significantly shorter in group G than in group F.The number of glottic exposure with glidescope were fourteen patients（70%） and epiglottic exposure were six patients（30%） in group G.There was no significant difference in hemodynamics between group G and group F.There was no adverse effects sore throat or hoarseness after operation in the two groups.Conclusion FOB-guided nasotracheal intubation with Glide-Scope no increase cardio vascular response during operation but shorten the intubation time in patients undergoing cervical spine surgery.

关 键 词：颈椎 脊柱疾病 喉镜检查 支气管镜检查 插管法 气管内 麻醉 全身 

分 类 号：R614.2[医药卫生—麻醉学] R681[医药卫生—外科学]