梨状窝定位经口盲探插管法在预计有困难气管插管中的临床应用  

Clinical application of piriform recess localization assisted blind orotracheal intubation in endotracheal intubation with predicted difficulties

作　　者：钟钦文[1] 叶军明[2] 徐世元[1] 

机构地区：[1]南方医科大学珠江医院麻醉科,广州市510280 [2]江西省赣南医学院第一附属医院麻醉科,341000

出　　处：《实用医学杂志》2015年第3期395-397,共3页The Journal of Practical Medicine

摘　　要：目的:评价梨状窝定位经口盲插法气管插管在预计有困难气管插管的效果及安全性。方法:40例预计有困难气管插管的全麻患者随机均分为两组:S组和L组,分别以视可尼可视喉镜和梨状窝定位经口盲探法行气管插管,记录麻醉诱导前后呼吸、循环情况;插管成功率、插管时间及并发症情况。结果:尽管S组和L组第1次插管成功率为85%和60%(P=0.08),但插管总成功率均为100%,而且L组插管时间明显低于S组[(16.10±9.14)s vs(42.80±15.43)s,P=0.000];插管过程中,两组Sp O2均能保持97%以上,MAP、HR虽有一定波动,但很快恢复,两组间比较差异无统计学意义;并发症方面,两组比较差异均无统计学意义。结论:梨状窝定位经口盲探气管插管法,操作简便、成功率高、并发症少,有助于解决困难气管插管。Objective To explore efficacy and safety of pyriform sinus localization-assisted blind orotracheal intubation in endotracheal intubation with predicted difficulties. Methods 40 patients ready for endotracheal intubation with predicted difficulties were randomly divided into blind orotracheal intubation group （L group） and Shikai Optical Style group （SOS group）, 20 cases in each. The two groups were compared in terms of respiration and circulation before and after anesthesia induction, intubation success rate, intubation time and complications. Results The total intubation success rate in L group was similar to that in S group （100%）. The first-time success rate was 60% vs. 85%, respectively （P = 0.08）. The intubation time of the first successful intubation in L group was significantly shorter than in S group （16.10 ± 9.14 vs. 42.80 ± 15.43; P = 0.000）. During intubation, SpO2 was maintained at 〉 97% and MAP and HR increased but soon returned to normal in both groups, showing statistical insignificance. The postoperative complication rate was similar between the two groups without statistical significance. Conclusion Pyriform sinus localization-assisted blind orotracheal intubation is equally or slightly more effective than SOS in terms of intubatin success rate, intubation time and postoperative complication rate. Thus, this method should be beneficial in management of difficult endotracheal intubation.

关 键 词：梨状窝 盲探插管 视可尼可视喉镜 困难气道 气管插管 

分 类 号：R614[医药卫生—麻醉学]