HC视频喉镜联合纤维支气管镜在颈椎制动患者气管插管中的应用  

Application of HC video laryngoscope combined with fiberoptic bronchoscopy in tracheal intubation in patients with cervical spine immobilization

作　　者：单汉民[1] 余亮[1] 吴鹤芬[1] Han-min Shan;Liang Yu;He-fen Wu(Department of Anesthesiology, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China)

机构地区：[1]浙江省湖州市中心医院麻醉科,浙江湖州313000

出　　处：《中国内镜杂志》2017年第3期64-68,共5页China Journal of Endoscopy

摘　　要：目的探讨HC视频喉镜联合纤维支气管镜在颈椎制动患者气管插管中应用。方法选择颈椎制动拟全麻手术患者80例随机分为纤维支气管镜组(F组),HC视频喉镜复合纤维支气管镜经鼻插管组(H组),每组40例。充分局部麻醉及静脉麻醉后,保留自主呼吸,行气管插管。记录诱导前(T_0)、气管插管前即刻(T_1)、气管插管后即刻(T_2)、气管插管后1 min(T3)平均动脉压(MAP)、心率(HR)变化,记录首次插管成功率、插管时间。记录气管插管操作相关并发症发生率。结果两组患者气管插管前即刻(T_1)MAP和HR差异无统计学意义(t=0.75、-0.51,P=0.453、P=0.611);两组插管后即刻(T_2)MAP和HR较气管插管前即刻(T_1)MAP(t=5.08、4.36,P=0.021、P=0.013)和HR(t=7.22、6.54,P=0.026、P=0.031)差异均有统计学意义(P<0.05),血流动力学均维持在正常范围,两组间比较MAP和HR差异均无统计学意义(t=-0.51、-0.31,P=0.411、P=0.518);插管后1 min(T3)两组间比较MAP和HR差异均无统计学意义(t=0.38、0.26,P=0.681、P=0.372)。H组患者首次气管插管成功率明显高于F组,差异有统计学意义(χ2=7.31,P=0.007)。两组气管插管时间H组明显少于F组,差异有统计学意义(t=5.75,P=0.000)。F组患者术后咽痛发生率明显高于H组,差异有统计学意义(χ2=5.00,P=0.025)。结论颈椎制动患者经鼻气管插管中,HC可视喉镜联合纤维支气管镜,较传统纤维支气管镜插管,首次插管成功率更高,插管时间更短,不加重血流动力学波动,咽痛发生率更低。Objective To explore the application of HC video laryngoscope combined with fiberopticbronchoscopy in tracheal intubation in patients with cervical spine immobilization.Methods80cases of cervicalspine immobilization to surgery patients under general anesthesia were randomly divided into bronchoscopy group(Fgroup),HC video laryngoscope composite fiber bronchoscope nasotracheal intubation group(H group),40cases ineach group.Full of local anesthesia and intravenous anesthesia,spontaneous breathing,tracheal intubation.Recordedbefore induction(T0),immediately before intubation(T1),immediately after intubation(T2),1minutes after trachealintubation(T3)mean arterial pressure(MAP),heart rate(HR)changes,record for the first time intubation successrate,intubation time of patients.The incidence of complications related to intubation operation.Results there wereno significant differences between the two groups before and after tracheal intubation(T1)MAP and HR(t=0.75,-0.51,P=0.453,0.611);After the two groups were intubated immediately(T2),MAP and HR than immediatelybefore intubation(T1),the differences were statistically significant MAP(t=5.08,4.36,P=0.021,0.013)and HR(t=7.22,6.54,P=0.026,0.031),hemodynamics were maintained in the normal range,after intubation immediately(T2)between the two groups compared differences in MAP and HR had no statistical significance(t=-0.51,-0.31,P=0.411,0.518);There was no significant difference in HR and MAP between the two groups(t=0.38,0.26,P=0.681,0.372)in1min after intubation(T3).Patients with tracheal intubation success rate for the first time Hgroup was obviously higher than that of group F,the difference was statistically significant(χ2=7.31,P=0.007).The two group intubation time in H group was significantly less than that in F group,the difference was statisticallysignificant(t=5.75,P=0.000).The incidence of sore throat in group F was significantly higher than H group,the difference was statistically significant(χ2=5.00,P=0.025).Conclusions The patients with cervical spineimmobilizat

关 键 词：HC视频喉镜 纤维支气管镜 颈椎制动 气管插管 

分 类 号：R614[医药卫生—麻醉学]