光棒及纤维支气管镜在头面部烧伤插管中的应用  

Application of lightwand and fiberoptic bronchoscope on craniofacial burned patients with anticipated difficult airway

作　　者：宗林 倪洋林 王玉秀 袁光华 钱兆玲 

机构地区：[1]解放军82医院麻醉科,江苏淮安223001

出　　处：《东南国防医药》2011年第5期393-395,共3页Military Medical Journal of Southeast China

基　　金：南京军区医疗科技创新课题(08MA038)

摘　　要：目的比较光棒和纤维支气管镜引导下气管内插管成功率、插管时间和血流动力学的影响,评价光棒和纤维支气管镜在麻醉困难插管中的应用效果,为野战麻醉提供一种可行的通气方式。方法 40例头面部烧伤、炸伤,随机分光棒组(LW组)、纤维支气管镜组(FOB组)。根据综合气道评估分为Ⅱ～Ⅳ级,记录入室后、诱导后、插管后3 min的平均动脉压、心率、脉搏血氧饱和度及插管成功率、插管时间、口腔损伤、插管后并发症的发生情况。结果两组插管成功率都在98%以上。与LW组相比,FOB组插管时间短、成功率高。血流动力学影响、口腔损伤和并发症方面,两组无明显差异(P>0.05)。结论光棒与纤维支气管镜均可用于困难气管插管,成功率高、口腔损伤少、对血流动力学影响小,可用于战时烧伤、炸伤等大批量伤员急救及麻醉时困难气道的处理。Objective To compare the success rate and time of intubation,the injuries to oral cavity and the hemodynamic changes during tracheal intubation with the lightwand and the fiberoptic bronchoscope in craniofacial burned patients.Methods Forty craniofacial burned patients,scheduled for elective surgery under general anesthesia requiring tracheal intubation were randomly allocated to either the lightwand group（group LW） or the fiberoptic bronchoscope group（group FOB）.All patients were classified into class Ⅱ-Ⅳ according to Mallampati test,mouth opening and thyromental distance.Changes of hemodynamic parameters（MAP,HR,SpO2）were observed at three periods： ten minutes after entering the room,after induction of anesthesia,and three minutes after intubation.The rate of successful intubation,the time of intubation,injuries and incidence of airway complications of both groups were also observed.Results There was a little difference in successful intubation between the two groups（P〉0.05）.The changes of hemodynamic parameters（MAP,HR）,the injuries and the incidence of airway complications werent obvious in two groups.Conclusion Tracheal intubation using lightWand and fiberoptic bronchoscope are successful,safe,valid and less injurious.

关 键 词：烧伤 气管插管 光棒 纤维支气管镜 海上救护 

分 类 号：R614.2[医药卫生—麻醉学]