HC视频喉镜与Macintosh直接喉镜引导患儿气管插管术效果的比较  

Comparison of HC video-laryngoscope and Macintosh direct laryngoscope for tracheal intubation in pediatric patients

作　　者：何伟[1] 黄梦朦 刘铁帅[1] 张冰[1] 曾睿峰[1] 上官王宁[1] 连庆泉[1] 李军[1] 

机构地区：[1]温州医科大学附属第二医院麻醉科,325027

出　　处：《中华麻醉学杂志》2014年第11期1357-1360,共4页Chinese Journal of Anesthesiology

摘　　要：目的 比较患儿HC视频喉镜与Macintosh直接喉镜引导气管插管术的效果.方法 择期全麻手术患儿120例,ASA分级Ⅰ或Ⅱ级,性别不限,年龄1～6岁,Mallampati分级Ⅰ或Ⅱ级,采用随机数字表法分为2组（n=60）：HC视频喉镜组（H1组）和Macintosh直接喉镜组（M1组）.40例可能存在困难气道的全麻手术患儿,ASA分级Ⅰ或Ⅱ级,性别不限,年龄3～6岁,Mallampati分级Ⅲ或Ⅳ级,采用随机数字表法分为2组（n=20）：HC视频喉镜组（H2组）和Macintosh直接喉镜组（M2组）.麻醉诱导后,H1组和H2组用HC视频喉镜引导经口气管插管,M1组和M2组用Macintosh直接喉镜引导经口气管插管.采用Cormark-Lehane分级评价声门显露程度,记录气管插管时间、气管插管成功情况、H2组和M2组气管插管成功时的张口度;记录气管插管过程中口唇、牙齿、牙龈及咽喉部软组织损伤的发生情况和术后24 h声音嘶哑的发生情况.结果 与M1组比较,H1组气管插管时间、首次气管插管成功率和声门显露程度差异无统计学意义（P＞0.05）,气管插管过程中口唇、牙齿、牙龈、咽喉部软组织损伤和术后声音嘶哑的发生率降低（P＜0.05）.与M2组比较,H2组气管插管时间缩短,首次气管插管成功率升高,气管插管成功时张口度减小,声门显露程度降低,气管插管过程中口唇、牙齿、牙龈、软组织损伤和术后声音嘶哑的发生率降低（P＜0.05）.结论 HC视频喉镜引导患儿气管插管术操作简便、快捷,较Macintosh喉镜成功率高,刺激小,并发症少,可优先考虑用于困难气道患儿.Objective To compare HC video-laryngoscope and Macintosh direct laryngoscope for tracheal intubation in the pediatric patients.Methods One hundred and twenty pediatric patients,of ASA physical status [or Ⅱ （Mallampati class Ⅰ or Ⅱ）,aged 1-6 yr,scheduled for elective surgery under general anesthesia,were randomly divided into 2 groups（n =60 each） using a random number table：HC video-laryngoscope group （group H1） and Macintosh direct laryngoscope group （group M1）.Forty pediatric patients,aged 3-6 yr,of ASA physical status Ⅰ or Ⅱ （Mallampati class Ⅲ or Ⅳ,） suspected as having a difficult airway,scheduled for elective surgery under general anesthesia,were randomly divided into 2 groups （n =20 each） using a random number table：HC video-laryngoscope group （group H2） and Macintosh direct laryngoscope group （group M2）.After induction of anesthesia,orotracheal intubation was carried out by HC video-laryngoscope （group H1 and H2） or by Macintosh direct laryngoscope （group M1 and M2）.The exposure of the glottis was evaluated with Cormack-Lehane classification.The intubation time,rate of successful intubation,and distance between upper and lower incisors when intubation was successful in H2 and M2 groups were recorded.The development of damage to lips,teeth,gums and soft tissues of throat during intubation and hoarseness after operation was recorded.Results Compared with M1 group,no significant change was found in the intubation time,rate of successful intubation at first attempt and Cormark-Lehane grade,and the incidence of damage to lips,teeth,gums and soft tissues of throat during intubation and hoarseness after operation was significantly decreased in group H1.Compared with group M2,the intubation time was significantly shortened,the rate of successful intubation at first attempt was increased,the distance between upper and lower incisors when intubation was successful was reduced,Cormark-Lehane grade was decreased,and the incidence of damage to lips,teeth,gums an

关 键 词：喉镜 插管法 气管内 儿童 

分 类 号：R726.1[医药卫生—儿科]