HC可视喉镜在急诊低年资住院医师紧急气管插管操作中的应用  

The usage of HC visual laryngoscope for emergency tracheal intubation by unskilled junior emergency resident doctors

作　　者：潘龙飞[1] 余蕾[2] 裴红红[1] 樊媛[1] 王晓博[1] 苏利娟[1] 黄婉[1] 

机构地区：[1]西安交通大学第二附属医院急诊科,西安710004 [2]西安医学院,西安710021

出　　处：《中华急诊医学杂志》2016年第7期910-914,共5页Chinese Journal of Emergency Medicine

摘　　要：目的 研究采用HC可视喉镜是否可以提高急诊低年资住院医师紧急气管插管的效率及成功率。方法 选取急诊科需要进行紧急气管插管的患者共计80例，首先随机（随机数字法）分为低年资住院医师组（A组）及高年资主治医师组（B组），然后每组再随机分为HC可视喉镜插管组（HC组）及传统光学喉镜插管组（N组），比较每组的声门暴露成功率、一次插管成功率、插管总成功率、并发症情况以及成功插管病例的平均尝试次数和平均插管时间。结果 （1）A-HC组的声门暴露成功率、一次插管成功率、插管总成功率依次为90%、70%、90%，均高于A-N组，依次为50%、20%、45%，P＜0.05；并发症总发生率、成功插管病例的平均尝试次数、平均插管时间依次为15%、（1.28±0.43）次、（31.44±5.06）s，均低于A-N组，依次为45%、（1.89±0.79）次、（45.89±4.99）s，P＜0.05；（2）B-N组的声门暴露成功率、一次插管成功率、插管总成功率依次为80%、65%、80%，均高于A-N组，依次为50%、20%、45%，P＜0.05；并发症总发生率、成功插管病例的平均尝试次数、平均插管时间依次为15%、（1.25±0.41）次、（39.31±4.23）s，均低于A-N组，依次为45%、（1.89±0.79）次、（45.89±4.99）s，P＜0.05；（3）A-HC组与B-HC组的上述各项指标比较，差异无统计学意义（P＞0.05）。结论 HC可视喉镜用于急诊低年资住院医师的紧急气管插管操作时，可提高声门暴露成功率、减少尝试次数、降低并发症发生率、缩短插管时间，可以提高紧急气管插管的效率及成功率，并且可能缩小其与高年资主治医师紧急气管插管操作的差距。Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation. Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly （ random number）. Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors. Then, the two groups of patients above were divided into two groups randomly （ random number）. Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope. Then comparisons of the success rate of glottis exposure, the one-time success rate of tracheal intubation, the success rate of tracheal intubation, the complications, the number of attempt in successfulintubation cases and the operative time consumed for successful intubation cases among the groups were done. R^ults （ 1 ） The success rate of glottis exposure, the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%, 70% and 90%, respectively which were significantly higher than those （50%, 20% and 45% ） in group A-N （P 〈0. 05） . The rate of complication, the number of attempt and operative time consumed for intubation cases in group A-HC were respectively 15%, （ 1.28 ±0. 43） and （31.44 ± 5.06） s, which were significantly less than those [ 45%, （1.89 ± 0. 79 ） and （45.89 ±4. 99） s in group A-N （P 〈 0. 05）. （2） The success rate of glottis exposure, the one-time success rate and the success rate of tracheal intubation in group B-N were 80%, 65% and 80%, respectively which were significantly higher than those （50%, 20% and 45% ） in group A-N （P 〈 0. 05 ）. The rate of complication, the number of attempt and operative time consumed for successful intubation cases in group B-N were 15%, （1.25 ±0. 41 ） and

关 键 词：HC可视喉镜 急诊 低年资住院医师 紧急气管插管 

分 类 号：R459.7[医药卫生—急诊医学]