柔性光索探条联合插管型喉罩辅助用于Mallampati评分3～4级老年病人的气管插管  

Application of the flexible lightwand combined with intubating laryngeal mask airway in intubation in elderly patients with Mallampati score 3 to 4

作　　者：尹楠[1] 汪小海[2] 柴茂[2] 陈洁[2] 孙强[3] 

机构地区：[1]南京医科大学,江苏省南京市210029 [2]南京医科大学鼓楼临床医学院(南京鼓楼医院)麻醉科,江苏省南京市210008 [3]南京医科大学附属口腔医院麻醉科,江苏省南京市210029

出　　处：《实用老年医学》2018年第1期39-42,共4页Practical Geriatrics

摘　　要：目的探讨柔性光索探条联合插管型喉罩辅助气管插管在老年病人中的可行性以及效果。方法择期手术病人60例,Mallampati评分3~4级,ASAⅠ~Ⅲ级,年龄60~83岁。采用随机数字表法均分为柔性光索探条联合插管型喉罩组(研究组)和光棒辅助气管插管组(对照组),每组30例。记录麻醉前、麻醉诱导后、插管即刻、插管后1 min、3 min及5 min时收缩压(SBP)、舒张压(DBP)、心率(HR)的变化,以及插管时间、插管次数、插管首次成功率、总体成功率及有无咽喉痛、声嘶等并发症,并进行组间比较。结果 2组病人性别、年龄、体质量等一般情况差异无统计学意义(P>0.05)。与麻醉诱导前比较,2组气管插管即刻、插管后1 min、3 min、5 min的SBP、DBP和HR差异无统计学意义(P>0.05)。所有病人均气管插管成功。研究组与对照组比较,首次插管成功率差异无统计学意义,插管操作平均时间显著延长(P<0.05),术后咽喉部疼痛率显著降低(P<0.05)。结论柔性光索探条联合插管型喉罩辅助气管插管用于Mallampati评分3~4级老年病人具有成功率高和并发症少等特点。Objective To explore the feasibility and outcome of flexible lightwand combined with intubating laryngeal mask airway（ILMA） in intubation in elderly patients with Mallampati score 3 to 4.Methods Sixty patients（ASA Ⅰ-Ⅲ,60-83 years old,and Mallampati score 3-4） undergoing elective surgeries were enrolled in this study.All patients were randomly divided into two groups： flexible lightwand intubation group（experiment group,n = 30） and traditional lightwand guided intubation group（control group,n = 30）.Hemodynamic parameters including systolic blood pressure（SBP）,diastolic blood pressure（DBP）,and heart rate（HR）,were recorded at the following time points： before or immediately after anesthesia induction,1 min,3 min,and 5 min after intubation.Intubation time,successful rate of the first-time intubation,overall successful rate of intubation,and complications such as sore throat and hoarseness were also recorded.Results There were no significant difference in gender,age,weight between two groups（P〈0.05）.The levels of SBP,DBP,and HR immediately after anesthesia induction,1 min,3 min,and 5 min after intubation in two groups showed no significant differences with those before anesthesia induction（P〈0.05）.Tracheal intubation were completed successful in all patients.There was no significant difference between control group and experiment group in the successful rate of first-time intubation.Compared to the control group,experiment group had longer average operation time and lower incident rate in sore throat（P0.05）.Conclusions Flexible lightwand combined with ILMA in intubation shows a longer operation time but fewer complications for elderly patients with Mallampati score 3 to 4.

关 键 词：光棒 光索探条 插管型喉罩 气管插管 

分 类 号：R614.21[医药卫生—麻醉学]