Airtraq喉镜联合弹性插管探条在预计困难气道支气管插管中的应用  

Utilization of Airtraq laryngoscope combined with gum elastic bougie in expected difficult airway for bronchial intubation

作　　者：刘涛[1] 李明强[1] 周立文[1] 

机构地区：[1]襄阳市中心医院麻醉科,441021

出　　处：《国际麻醉学与复苏杂志》2016年第2期145-148,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的 比较Airtraq喉镜联合弹性插管探条（gum elastic bougie,GEB）和纤维支气管镜（fiberoptic bronchoscope,FOB）在预计困难气道患者支气管插管中的效果.方法 择期行右侧单肺通气的胸外科手术患者48例,张口度大于3 cm,Mallampati分级Ⅲ或Ⅳ级,随机数字表法分为两组（每组24例）：Airtraq喉镜联合GEB组（A组）和FOB组（F组）.记录插管首次成功率、置管时间、支气管对位用时和气道损伤情况,记录麻醉诱导前和支气管对位成功后2 min时点的SBP、DBP、HR和血浆去甲肾上腺素（norepinephrine,NE）浓度.结果 插管首次成功率A组与F组差异无统计学意义（91.7％比95.8％,P＞0.05）;A组置管时间[（91±17）s]短于F组[（105±19） s]（P＜0.05）;A组支气管对位用时[（132±34）s]长于F组[（55±12）s]（P＜0.05）;气道损伤并发症两组之间差异无统计学意义（P＞0.05）.两组SBP、DBP、HR和血浆NE浓度在插管完成后2 min均较麻醉诱导前明显升高（P＜0.05）,且A组高于F组（P＜0.05）.结论 Aiaraq喉镜联合GEB用于预计困难气道支气管插管与FOB一样安全有效,但支气管对位较慢,心血管应激反应较大.Objective To compare the effect of Airtraq laryngoscope combined with gum elastic bougie （GEB） and fiberoptic bronchoscope （FOB） in expected difficult airway for bronchial intubation.Methods Forty eight patients scheduled for chest surgery with elective right one-lung ventilation, with gape dim over 3 cm, of Mallampati physical status Ⅲ or Ⅳ, were randomly assigned into 2 groups （n=24）： Airtraq laryngoscope combined with gum elastic bougie group （group A） and fiberoptic bronchoscope group （group F）.The achievement ratio of first intubation, intubation time, bronchial positioning time, occurrence of airway injury were recorded respectively.SBP, DBP, HR, and plasma level of norepinephrine （NE） were also recorded or measured before anesthesia induction and 2 min after bronchial positioning.Results There was no significant difference in the achievement ratio of first intubation between two groups（91.7% vs 95.8%, P〉0.05）.The intubation time was shorter in group A than that in group F [（91±17） s vs （105±19） s, P〈 0.05].The bronchial positioning time was longer in group A than that in group F [（132±34） s vs （55±12） s, P〈0.05].There was no significant difference in occurrence of airway injury between two groups （P〉0.05）.Compared with that before anesthesia induction, SBP, DBP, HR, and plasma level of NE at 2 min after bronchial positioning increased significantly （P〈0.05）.Conclusions Airtraq laryngoscope combined with gum elastic bougie is as safe and helpful as fiberoptic bronchoscope in difficult airway management for bronchial intubation.However, it is with a longer bronchial positioning time and elicits significant cardiovascular stress response.

关 键 词：AIRTRAQ喉镜 弹性插管探条 双腔支气管导管 纤维支气管镜 

分 类 号：R614[医药卫生—麻醉学]