McGrath-5型视频喉镜与McCoy喉镜引导困难气道双腔支气管插管的效果比较  

Comparison of McGrath-5 video-laryngoscope and McCoy laryngoscope guided double-lumen tube intubation in patients with difficult airway

作　　者：沈荣荣[1] 杨鑫[1] 李樱青[1] 严峰[1] 王浩杰[1] 

机构地区：[1]浙江省余姚市人民医院麻醉科,浙江余姚315400

出　　处：《中国内镜杂志》2016年第9期15-19,共5页China Journal of Endoscopy

基　　金：余姚市科技计划项目(No:2014Y07)

摘　　要：目的探讨Mc Grath-5型视频喉镜与Mc Coy喉镜在困难气道双腔支气管插管的临床应用效果。方法选择预计双腔支气管插管困难的择期手术患者60例,采用随机数字表法,将其随机分为两组:Mc Grath-5型视频喉镜组(A组,n=30)和Mc Coy喉镜组(B组,n=30)。常规诱导后分别用两种喉镜引导经口插管,对两组患者一次插管成功率、插管时间、定位成功率、插管时间内脉搏血氧饱和度(Sp O2)<90%次数、环状软骨按压例数、插管并发症发生情况和血流动力学指标:诱导前(T0)、置入喉镜暴露声门时(T1)、导管进入声门即刻(T2)、插管后3 min(T3)各时间点记录患者收缩压(SBP)、心率(HR)和脑电双频指数(BIS)值的变化进行分析。结果 A组患者环状软骨按压例数明显低于B组(P<0.05),插管时间明显高于B组(P<0.05);两组患者T3时点的SBP和HR较T0时点均明显降低(P<0.05),A组患者T1、T2时点SBP和HR均明显低于B组(P<0.05)。结论与Mc Coy喉镜相比,Mc Grath-5型视频喉镜引导经口双腔导管插管对血流动力学的影响较小,插管并发症较少,插管时间虽延长但不至于影响患者氧供,为临床解决困难气道双腔插管提供一种良好选择。Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method： McGrath-5 video-laryngoscope group （group A, n = 30） and McCoy laryngoscope group （group B, n = 30）. All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 〈 90% within intuhation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction （To）, glottic exposure upon laryngoscope insertion （TO, immediately after intubation （T2）, 3 min （T3） after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B （P 〈 0.05）, whereas the intubation time in group A was significantly higher than that in group B （P 〈 0.05）. The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at To in both groups （P 〈 0.05）. The systolic pressure and heart rate at T, and T2 in group A were considerably lower in group A than those in group B （P 〈 0.05）. Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient＇s oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.

关 键 词：MC Grath–5型视频喉镜 MC Coy喉镜 双腔导管 插管法 气管内 

分 类 号：R614[医药卫生—麻醉学]