视频喉镜和直接喉镜在面颈部瘢痕困难气道管理中的应用  

Comparison of Truview^(TM) EVO_2 video laryngoscope and Macintosh laryngoscope for management of difficult airway in patients with neck burn scar

作　　者：徐德朋 张燕燕 文晓兵 周文 袁丽丽 江学成 

机构地区：[1]解放军97医院麻醉科,江苏徐州221004

出　　处：《东南国防医药》2015年第1期26-28,共3页Military Medical Journal of Southeast China

基　　金：南京军区医学科技创新项目(MS038)

摘　　要：目的探讨TruviewTMEVO2视频喉镜在烧伤后面颈部瘢痕患者困难气道管理中应用价值。方法选择烧伤后面颈部瘢痕需全麻插管下手术和困难气道评估Lemon≥2分患者,根据住院序列单双号分为TruviewTMEVO2视频喉镜组(T组)和Macintosh直接喉镜组(M组)。两组均采用全麻诱导后尝试性插管,对直接影响插管的面颈部瘢痕而且明显不能用传统喉镜者先行瘢痕松解。观察记录声门暴露时间、插管成功的尝试次数、插管时间、成功与否、有无助手辅助、镜下Cormack分级及插管成功率。结果 Lemon≥2分的118例,M组57例,T组61例。M组和T组Lemon分分别为(3.46±1.73)和(3.22±1.12)。T组声门显露Cormack分级均为Ⅰ~Ⅱ级(100%),而M组Ⅰ~Ⅱ级仅28例(31.6%)。T组插管次数、声门暴露时间、插管总时间及助手辅助情况明显好于或短于M组(P<0.01),但T组导管置入时间明显长于M组(P<0.01)。M组首次插管35例成功(61.4%),T组首次插管61例成功(100%,P<0.01)。结论面颈部瘢痕困难气道中,TruviewTMEVO2视频喉镜显露声门较好,插管相对容易和安全。Objective To explore application of the Truview TM EVO2 video laryngoscope in management of difficult airway in patients with the neck burn scar .Methods Surgical patients under general anesthesia and intubation were divided into Truview TM EVO2 video （Group T） and Macintosh laryngoscope （Group M）.The attempted intubation was carried out after induction of general anesthesia in both groups .The scars first were released in patients with cervicofacial scar that can not carry out intubation with tradi -tional laryngoscope .Observing and recording contents included Cormack scale intubation time , times, succeed cases and so on .Re-sults There were 118 patients with Lemon ≥2 points, 57 in group M and 61 in group T.Lemon score （3.46 ±1.73） and （3.22 ± 1.12） in group M and T.The glottis exposure of 61 patients were all Cormack grade ⅠorⅡ（100%） in group T.The glottis expo-sure of 28 patients （31.6%） were gradeⅠorⅡin group M.The glottis exposure time , number of attempt intubation , total time were significantly better in group T than in group M （P〈0.01）.The intubation time takes significantly longer in group T than in group M （P〈0.01）.Intubation were successful in 35 of 57 patients （61.4%） in group M.The intubation success rate （100%） was signifi-cantly higher in group T than in group M （P〈0.01）.Conclusion In management of difficult airway in patients with the neck burn scar, TruviewTM EVO2 video laryngoscope for glottis exposure , intubation is relatively easy and safe .

关 键 词：困难气道 面颈部瘢痕 视频喉镜 气管插管 

分 类 号：R614.2[医药卫生—麻醉学]