McGrath可视喉镜与Macintosh直接喉镜显露颈椎手术患者喉部结构的比较  

A comparison between the McGrath videolaryngoscope and the Macintosh laryngoscope for laryngeal viewing in patients receiving cervical vertebral surgery

作　　者：张恒胜 包睿[2] 范晓华[2] 李金宝[2] 马宇[2] 邓小明[2] 

机构地区：[1]江苏省扬州市洪泉医院麻醉科,225201 [2]上海市第二军医大学附属长海医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2013年第7期588-590,599,共4页International Journal of Anesthesiology and Resuscitation

基　　金：长海医院教学改革基金（GHJG2011005）

摘　　要：目的比较McGrath可视喉镜与Macintosh直接喉镜显露颈椎手术患者喉部结构的效果。方法50例颈椎手术患者采用随机数字表法随机分为McGrath组和Macintosh组，每组25例。麻醉诱导后，McGrath组先用Macintosh直接喉镜显露喉部结构并记录Cormack-Lehane分级（C／L分级），不插管，再改用McGrath可视喉镜显露喉部结构并插入气管导管。Macintosh组先用McGrath可视喉镜显露声门，再使用Macintosh直接喉镜显露喉部结构并插管。记录患者一般情况、气道评估指标（甲颏间距、张口度、Mallampati分级、颈部活动度）、喉镜显露C／L分级和插管并发症。结果两组间患者一般情况和气道评估指标差异无统计学意义（P〉0．05）。McGrath可视喉镜的C／L分级（I级：II级：III级为34：14：2）显著优于Macintosh直接喉镜（I级：II级：III级为13：32：5，19〈0．01）。结论McGrath可视喉镜对喉部结构的显露优于Macintosh直接喉镜，提示该可视喉镜有助于颈椎手术患者的气管插管处理。Objective To compare the laryngeal viewing of the McGrath videolaryngoscope and the Macintosh laryngoscope in patients receiving cervical vertebral surgery. Methods Fifty patients scheduled for elective cervical vertebral surgery were randomly divided into McGrath and Macintosh groups （n=25）. After induction, the patients glottis in McGrath group was displayed by the Macintosh laryngoscope and the Cormack Lehane （C/L） grade was recorded, and then the McGrath videolaryngoscope was employed to display the laryngeal structure. The order of laryngoscopy was reversed in the Macintosh group. Parameters recorded included demographics,airway assessment features （thyromental distance, mouth opening, mallampati oropharyngeal scale and neck movement）, C/L grade and complications of intubation. Results There was no significant difference in demographics and airway assessment features between the two groups （P〉0.05）. The C/L grade obtained with McGrath videolaryngoscope was 34：14：2 （ I ： II ： III ）, which was significantly better than that with Macintosh laryngoscope （ 13：32：5,P〈0.01 ）. Conclusions The McGrath videolaryngoscope has better laryngeal viewing than the Macintosh laryngoscope,and may have potential advantages in managing the intubation for cervical vertebral surgery.

关 键 词：McGrath可视喉镜 MACINTOSH直接喉镜 喉部结构显露 气管插管 

分 类 号：R614[医药卫生—麻醉学]