VL300L便携式可视喉镜在急诊困难气道插管中的应用研究  

Application of VL300L portable video laryngoscope in the intubation of the acute difficult airway

作　　者：鄢来超[1] 许国斌[1] 朱金强[1] 张近波[1] 曹烈祥[1] 董美平[1] 吴仙丹[1] 

机构地区：[1]温州医科大学附属温岭医院EICU,浙江温岭317500

出　　处：《中国现代医生》2016年第25期128-131,共4页China Modern Doctor

基　　金：浙江省温岭市科技局科技计划项目(2012WLCA0065)

摘　　要：目的探讨VL300L便携式可视喉镜在急诊困难气道经口气管插管时的临床价值。方法收集2012年9月～2016年5月我院Mallampati分级Ⅲ-Ⅳ级的92例患者，其中48例使用VL300L便携式可视喉镜（V组），44例使用Macintosh直视喉镜（M组），两组均联合使用硬质管芯；比较两组声门显露时间、气管导管置入时间、一次性插管成功率、插管前后3min平均动脉压（MAP）、插管前后3min心率（HR）、咽喉部并发症等。结果在急诊困难气道经口气管插管时，VL300L便携式可视喉镜组较Macintosh直视喉镜组的声门显露时间明显缩短（P〈0．05），气管导管置入时间较M组短（P=0．01），一次性插管成功率较M组明显提高（P〈0．05），两组咽喉部并发症情况比较，差异无统计学意义（P〉0．05）；两组插管后3min平均动脉压、心率较插管前均有明显上升（P均〈0．05）。但VL300L便携式可视喉镜组较Macintosh直视喉镜组升高程度小（P均〈0．05）；两组咽喉部并发症比较差异无统计学意义（χ^2=2．381，P〉0．05）。结论VL300L便携式可视喉镜用于急诊困难气道经口气管插管时能有效避免职业暴露，减少血流动力学影响，便于临床教学，较Macintosh直视喉镜有优势，值得推广应用。Objective To evaluate the clinical value of VL300L portable video laryngoscope in emergency treatment of difficult airway intubation. Methods A total of 92 patients with Mallampati grade Ⅲ-Ⅳ were collected from September 2012 to May 2016 in our hospital and divided into two groups according to the kinds of laryngoscopes, which including VL300L portable video laryngoscope （n=48, V-group） and Macintosh direct laryngoscope （n=44, M-group）. After treated with hard core,the exposure time, tracheal intubation time, success rate of one-time intubation, the mean arterial pressure （MAP） and heart rate （HR） at 3 minutes before and after intubation,throat complications and others were compared between the two groups. Results The exposure time of glottis in V-group was less then than that of M-group（P〈0.05）. The time of tracheal intubation was significantly different between the two groups（P=0.01）. The success rate of one-time intubation increased obviously in V-group （P〈0.05）. Although, the mean arterial pressure and heart rate after intubation were higher than before in each group （P〈0.05）, but the change of V-group was smaller than that of M-group （P〈0.05）. There was no significantly differentce in the incidence of throat complications between the two groups （χ^2=2.381; P〉 0.05）. Conclusion Less occupational exposure and weaker hemodynamie effects displayed when suffering from VL300L portable video laryngoscope compared with Macintosh direct laryngoscope in emergency treatment of difficult airway intubation. VL300L portable video laryngoscope should be a priority selection in clinical practice and teaching.

关 键 词：可视喉镜 困难气道 气管插管 直视喉镜 

分 类 号：R614.2[医药卫生—麻醉学]