McCoy喉镜、UE可视喉镜与纤维支气管镜在肥胖患者气管插管中的应用对比  

Comparison of McCoy Laryngoscope,UE Video Laryngoscope and Bronchofibroscope on Obese Patients with Intratracheal Intubation Anesthesia

作　　者：裴淼 华丽[1] 魏江涛[1] 姜敏[1] PEI Miao;HUA Li;WEI Jiangtao(Department of Anesthesiology,Affiliated Hospital of Chengdu University,Chengdu City,Sichuan Province 610000)

机构地区：[1]成都大学附属医院,四川省成都市610000

出　　处：《医学理论与实践》2018年第14期2067-2069,共3页The Journal of Medical Theory and Practice

摘　　要：目的:对比Mc Coy喉镜、UE可视喉镜及纤维支气管镜用于肥胖患者气管插管的效果差异。方法:66例在我院接受全麻手术的肥胖患者被纳入研究,根据其插管方式的不同,随机分为Mc Coy喉镜组(A组)、UE可视喉镜组(B组)及纤维支气管镜组(C组),每组22例。记录各组患者的插管情况、插管前后血流动力学变化和插管相关并发症情况。结果:B、C组患者镜下声门显露程度Cormack-Lehane分级Ⅰ级率及一次插管成功率明显高于A组(P<0.05),平均插管时间低于A组(P<0.05);C组相较于A组咽喉部渗血发生率更低(P<0.05);三组患者在插管后即刻及1min时,出现了心率血压的明显上升,与插管前基础值之间差异有统计学意义(P<0.05);C组插管后心率、血压的波动小于A组(P<0.05)。结论:UE可视喉镜、纤维支气管镜均能改善肥胖患者的声门暴露程度,提高插管成功率,缩短插管时间,值得推广。与可视喉镜相比,纤支镜气管插管引起的血流动力学改变更小,对于有循环系统基础疾病的患者更为适宜。Objective： To compare the effects of Mc Coy laryngoscope,UE video laryngoscope and bronchofibroscope on obese patients with intratracheal intubation anesthesia. Methods： 66 cases of obese patients with intratracheal intubation anesthesia were randomly divided into three groups with 22 each,based on the different instruments used during intubation： via McCoy laryngoscope（ group A）,via UE video laryngoscope（ group B）,via bronchofibroscope（ group C）. The details of intubation process,the variations of hemodynamic parameters and related complications were all recorded. Results： Compared with group A,group B,C had better performance in Cormack-Lehane classification,and the one-time success rate of tracheal intubation in the two groups were higher,with a relatively lower tracheal intubation time（ P〈0. 05）. All groups in the research showed a significant increase in heart rate（ HR） and mean arterial pressure（ MAP） soon after intubation（ P〈0. 05）,it also turned out that the hemodynamic parameters of group C remained more stable than group A（ P〈0. 05） and the throat injury cases were less in group C than in group A（ P〈0. 05）. Conclusion： Both UE video laryngoscope and bronchofibroscope are suitable for tracheal intubation of obese patients,with an advantage of better glottis exposure,shorter intubation time and higher rate of successful one-time tracheal intubation. Consider of the changes in hemodynamic parameters,bronchofibroscope maybe more appropriate for patients with cardiovascular diseases.

关 键 词：气管插管 MCCOY喉镜 UE可视喉镜 纤维支气管镜 肥胖 

分 类 号：R619[医药卫生—外科学]