帝视观察用内窥镜在清醒困难气管插管的应用  

Application of Disposcope during oral tracheal intubation in conscious patients with difficult airway

作　　者：方明[1,2] 王志萍[1] 李荣[2] 田皇华[2] 张中军[2] 吕国忠[3] 

机构地区：[1]徐州医学院麻醉学院,221004 [2]无锡市第三人民医院麻醉科 [3]无锡市第三人民医院烧伤整形科

出　　处：《江苏医药》2011年第22期2666-2668,共3页Jiangsu Medical Journal

摘　　要：目的评价帝视观察用内窥镜(DS)在清醒困难气管插管中的应用效果。方法 40例颈部烧伤后严重瘢痕挛缩患者随机应用DS(D组,20例)或纤维支气管镜(FBS)(F组,20例)引导清醒困难气管插管。所有患者均进行完善的咽喉部表面麻醉,并给予适量雷米芬太尼静脉镇痛。比较两组插管情况、循环变化和不良反应。结果 D、F两组一次插管成功率相仿(75%vs.80%),插管期呛咳反应发生率低,HR、MAP平稳。D组插管时间短于F组[(41.5±16.1)s vs.(52.2±13.5)s](P<0.05)。结论 DS能成功应用于引导清醒困难气管插管,具有与FBS相当的优势。Objective To evaluate the outcomes of oral tracheal intubation with Disposcope（DS） in conscious patients with difficult airway. Methods Oral tracheal intubation in conscious patients with difficult airway secondary to severe faciocervical postburn scar was performed with DS（group D,20 cases） or fiber bronchoscope（FBS）（group F,20 cases）.All patients were given sufficient surface anesthesia of upper respiratory tract and ramifentanil 0.1μg·kg-1·min-1 infusion before intubation. The changes of MAP,HR,SpO2,responses and perceptions during intubation were compared between two groups. Results Success rate of intubation by one time in group D was similar to that in group F（75% vs.80%）.MAP,HR and SpO2 were stable during intubation and response of patients to intubation was mild in both groups.The time spent on intubation was shorter in group D than that in group F [（41.5±16.1）s vs.（52.2±13.5）s]（P0.05）. Conclusion DS can be used effectively for oral tracheal intubation in conscious patients with difficult airway,which has the similar advantages to FBS.

关 键 词：困难气道 气管插管 帝视观察用内窥镜 纤维支气管镜 

分 类 号：R614[医药卫生—麻醉学]