可视喉镜在急诊紧急气管插管中的应用  

The clinical application of video-laryngoscope in spontaneous respiration tracheal intubation

作　　者：王虹虹[1] 曾红[1] 张林[1] 刘波[1] 陈辉[1] 

机构地区：[1]首都医科大学附属北京朝阳医院京西院区急诊中心,北京100043

出　　处：《中华急诊医学杂志》2012年第8期883-886,共4页Chinese Journal of Emergency Medicine

摘　　要：目的评估可视喉镜在急诊气管插管术中的临床价值和安全性。方法选取2010年1月至2010年12月首都医科大学附属北京朝阳医院（京西院区）急诊中心需紧急气管插管的患者79例，按就诊顺序随机（随机数字法）分为普通喉镜组（Timesco喉镜）（A组）40例和可视喉镜组（GlideScope可视喉镜）（B组）39例。观察两组患者C／L喉镜显露分级、插管时间、插管成功率以及不良反应；记录给药前（t0）、给药后／插管前（t1）、插管时（t2）、插管后2min（t3）各时间点的心率（HR）、平均动脉压（MAP）、呼吸频率（aa）、脉搏血氧饱和度（SpO：）。结果（1）C／L喉镜显露分级（I＋II／Ⅲ＋1V）A组明显高于B组（P〈0．05）；（2）B组插管时间为（35．6±12．7）S，明显短于A组插管时间（58．34-13．5）s；B组一次插管成功率（84．6％）明显高于A组（52．5％）（P〈0．05）；（3）与B组比较，A组患者t2、t，时间点HR及MAP增加显著（P〈0．05）；（4）A组患者躁动、呛咳、憋气和损伤等不良反应明显高于B组（P〈o．05）。结论可视喉镜用于急诊危重症气管插管术，改善喉镜显露分级、缩短插管时间，提高一次插管成功率。降低不良反应。Objective To assess the safety and clinical values of video-laryngoscope in spontaneous respiration tracheal intubation for emergency patients. Methods Seventy-nine patients, who needed the endotracheal intubation, were recruited in our department between January 2010 and December 2010, and were randomly （ random number） divided into two groups according to consultative sequence. Forty patients （group A ） were operated with traditional laryngoscope and thirty-nine patients （group B） with video- laryngoscope. The operative time and success rate of tracheal intubation, Cormack-Lehane classification, as well as adverse events, were recorded. The heart rate （ HR）, mean arterial blood press, re （ MAP）, respiratory rate （RR）, and saturation of pulse oxygen （SpO2） were observed pre-operafion, during operation and 2 rain pest-operation. Results （ 1 ） The Cormaek-Lehane classification in group A were significantly lower than in group B. （2） The operative time of tracheal intubation in group B was significantly less than that in group A [ （35.6 ＋ 12. 7） s vs. （58.3 ＋ 13. 5） s; P 〈0. 05] ; and one- time success rate of tracheal intubation in group B was higher than that in group A （84. 6% vs. 52. 5% ; P 〈 0. 05 ）. （3） Compared to group B, the HR and MAP in Group A were significantly increased at h and h （P 〈 0. 05 ）. （4） The adverse events, including restlessness, bucking and injury, were significantly decreased in group B than those in group A （ P 〈 0. 05）. Conclusions The video-laryngoscope used in spontaneous respiration tracheal intubafion, could improve Corulack-Lehane classification, short operative time, enhance one-time success rate and reduce adverse evevnts.

关 键 词：可视喉镜 急诊 气管插管术 C/L分级 并发症 

分 类 号：R614[医药卫生—麻醉学]