帝视观察用内镜在预计困难气管插管中的应用评价  

Application of Discopo in difficult endotracheal intubation

作　　者：赵霖霖[1] 葛东明[1] 张晓丽[1] 

机构地区：[1]上海交通大学附属第六人民医院麻醉科,上海200233

出　　处：《上海医学》2012年第10期829-832,共4页Shanghai Medical Journal

摘　　要：目的评价帝视观察用内镜(Discopo,简称帝视镜)在预计困难气管插管中的使用效果。方法选择62例美国麻醉医师学会分级Ⅰ或Ⅱ级预计困难气管插管的患者,分别采用帝视镜辅助下气管插管(帝视镜组,20例)、Glidescope视频喉镜(简称视频喉镜)辅助下气管插管(视频喉镜组,22例)和纤维支气管镜(简称纤支镜)辅助下气管插管(纤支镜组,20例)。记录3组患者麻醉诱导前、气管插管前即刻、显露声门时及气管插管后即刻的血压和心率,同时记录插管时间、一次气管插管成功率和气管插管后并发症(出血、声嘶、咽痛)发生情况。结果视频喉镜组有2例患者因气管插管失败退出研究。与同组麻醉诱导前比较,3组在气管插管前即刻及显露声门时的收缩压、舒张压和心率均显著降低(P值均<0.05),帝视镜组在气管插管后即刻的收缩压和舒张压均显著降低(P值均<0.05),3组在气管插管后即刻的心率均显著升高(P值均<0.05)。与同组气管插管前即刻比较,视频喉镜组在显露声门时的收缩压、舒张压和心率均显著升高(P值均<0.05),3组在气管插管后即刻的收缩压、舒张压和心率均显著升高(P值均<0.05)。帝视镜组在气管插管后即刻的收缩压和舒张压均显著低于视频喉镜组和纤支镜组(P值均<0.05),在气管插管后即刻的心率显著低于纤支镜组(P<0.05)。帝视镜组的插管时间为(34.3±11.9)s,显著短于视频喉镜组的(47.2±8.4)s和纤支镜组的(49.6±13.3)s(P值均<0.05)。纤支镜组的一次气管插管成功率达100%,显著高于帝视镜组的80%和视频喉镜组的75%(P值均<0.05)。3组间气管插管并发症发生率的差异无统计学意义(P值均>0.05)。结论帝视镜能安全有效地用于困难气管插管,并能显著减轻气管插管应激反应。Objective To evaluate the efficacy of Discopo in difficult endotracheal intubation.Methods A total of 62 patients,American Society fo Anesthesiologist（ASA）ⅠtoⅡ,in whom difficult endotracheal intubation was predicted,were divided into 3 groups.Discopo,Glidescope laryngoscope and fiberoptic bronchoscope were intubated in Discopo group（20 patients）,Glidescope group（22 patients） and FOB group（20 patients）,respectively.Blood pressure（BP） and heart rate（HR） were recorded before induction,before intubation,at the moment of glottis exposure and after intubation.Time-to-intubation,one-time success rate of intubation and complications（bleeding,hoarseness,and pharyngalgia） were also recorded.Results Two patients in Glidescope group were excluded from this study because of failed intubation.Systolic blood pressure（SBP）,diastolic blood pressure（DBP） and HR before intubation and at the moment of glottis exposure were significantly lower than those before induction in all patients（all P0.05）.SBP and DBP after intubation were significantly lower than those before induction in Discopo group（all P0.05）.HR after intubation was significantly higher than that before induction in all patients（all P0.05）.At the moment of glottis exposure,SBP,DBP and HR in Glidescope group were significantly higher than those before intubation（all P0.05）.SBP,DBP and HR after intubation in three groups were significantly higher than those before intubation（all P0.05）.After intubation,SBP and DBP in Discopo group were significantly lower than those in Glidescope group and FOB group（all P0.05）;HR in Discopo group was significantly lower than that in FOB group（all P0.05）.Time-to-intubation of Discopo group was significantly shorter than Glidescope group and FOB group（[34.3±11.9] s,[47.2±8.4] s,and [49.6±13.3] s,all P0.05）.One-time success rate of intubation of FOB group was significantly higher than those of Discopo group and Glidescope group（100%,80% and 75%,all P0.05）.The incid

关 键 词：帝视观察用内镜 GLIDESCOPE视频喉镜 纤维支气管镜 困难气管插管 

分 类 号：R614[医药卫生—麻醉学]