不同弯曲度导管芯用于Tosight~视频喉镜气管插管的比较  

Comparison of different stylet angulation and endotracheal tube camber on time to intubation with the Tosight~

作　　者：王烨[1] 温超[1] 邓晓明[1] 金锦花[1] 王玉慧[1] 徐文莉[1] 刘具会[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院麻醉科,北京市100144

出　　处：《临床麻醉学杂志》2014年第7期659-662,共4页Journal of Clinical Anesthesiology

摘　　要：目的：比较 Tosight视频喉镜气管插管时使用不同弯曲度导管芯的插管效果。方法120例18-55岁 ASA Ⅰ或Ⅱ级患者,无困难气道表征及病史,按导管芯的弯曲角度（弯折点在套囊上方的1 cm 内）随机均分为三组：A 组（弯曲为40°）、B 组（弯曲为60°）和 C 组（弯曲为80°）。快速诱导后采用 Tosight视频喉镜经口气管插管,观察记录三组 Tosight视频喉镜喉部显露分级、声门暴露时间、气管插管时间和插管次数和并发症的发生情况；记录插管期间的血流动力学变化。结果所有患者均成功完成气管插管操作,A、B 和 C 组的一次插管成功率分别为37例（92.5%）、39例（97.5%）和40例（100.0%）,A、B 组分别有3例和1例在改变导管芯角度第2次完成气管插管。三组的声门暴露时间差异无统计学意义,C 组插管总时间明显短于 A 组和 B 组（P 〈0.05）；三组插管期间无明显血流动力学改变,均无严重并发症。结论 Tosight视频喉镜用于成人气管插管时,三种导管芯的弯曲角度均能完成气管插管,其中80°的一次成功率最高,插管时间最短。Objective To compare the effect of different stylet angulation and endotracheal tube camber on time to intubation with Tosight video laryngoscope.Methods One hundred and twenty patients of 18 to 55 years old,ASA Ⅰ or Ⅱ,with no difficult airway signs and history,were random-ized into three groups with different endotracheal tube bending angle：group A（angle 40°）,group B （angle 60°）and group C（angle 80°）.For patients in all three groups,after rapid sequence induction, the Tosight oral intubation were applied.The Cormack-Lehane grading,glottic exposure time, times of tracheal intubation,hemodynamic response and complications were recorded.Results Tra-cheal intubation with the Tosight were successfully completed for all three groups.The success rate of first time intubation in groups A,B and C were 37 （92.5%）,39 （97.5%）and 40（100.0%）,respec-tively.3 patients in group A and 1 patient in group B finished the intubation with the second try after the stylet angle was changed.The mean time to glottic exposure had no significant difference in groups A,B and C.The time to complete tracheal intubation in group C was significantly shorter than that in groups A and B （P 〈 0.05 ）.There was no significant hemodynamic changes for all three groups,and no serious complications were detected.Conclusion When the Tosight is used for adult endotracheal intubation 40°,60°,80°angled stylets can all well assist endotracheal intubation.Among which 80°angled slylet has obvious advantages in intubation success rate and shortest intubation time.

关 键 词：Tosight视频喉镜 气管插管 管芯 角度 

分 类 号：R614[医药卫生—麻醉学]