Airtraq可视喉镜用于鼾症患者经鼻气管插管的前瞻性随机对照研究  

Airtraq Video Laryngoscope for Nasotracheal Intubation in Patients With Obstructive Sleep Apnea and Hyperpnoea Syndrome: Prospective Randomized Controlled Trial

作　　者：夏纯[1] 孙卓男[1] Xia Chun;Sun Zhuonan(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院麻醉科,北京100191

出　　处：《中国微创外科杂志》2018年第2期97-100,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学第三医院种子基金(Y84462-01)

摘　　要：目的比较Airtraq可视喉镜与Macintosh喉镜应用于阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hyperpnoea syndrome,OSAHS)患者经鼻气管插管的效果。方法选择我院2016年5~10月60例OSAHS择期行腭咽成形术,随机分为M组和A组2组,分别应用Macintosh普通喉镜和Airtraq经鼻可视喉镜经鼻气管插管,分别记录诱导前(T_0)、插管前(T_1)、气管插管即刻(T_2)、插管后第1分钟(T_3)和第5分钟(T_4)的血压和心率,气管插管时间,喉镜暴露分级(Cormach-Lehane分级)以及喉外部压迫操作、是否使用气管插管钳辅助和喉镜片沾血的发生率。结果 M组收缩压和心率在T_2、T_3、T_4时点均显著高于T_1时点(P<0.05),A组T_2、T_3、T_4时点收缩压、舒张压和心率之间无明显差异(P>0.05)。2组患者收缩压在T_2、T_3时点,心率在T_2、T_3和T_4时点有统计学差异(P<0.05),舒张压无统计学差异(P>0.05)。A组喉镜暴露分级显著优于M组(Z=-4.935,P=0.000);A组插管时间(30.4±9.0)s显著短于M组(42.3±16.5)s(t=-3.468,P=0.000)。结论 OSAHS手术经鼻气管插管时,Airtraq可视喉镜比Macintosh普通喉镜对血流动力学影响更小,插管时间更短,更有利于插管。Objective To compare the effect of nasotracheal intubation between Airtraq video laryngoscope and Macintosh laryngoscope in patients with obstructive sleep apnea and hyperpnoea syndrome(OSAHS). Methods A total of 60 patients with OSAHS receiving nasotracheal intubation were randomly divided into two groups:the group M was intubated with Macintosh laryngoscope and the group A was intubated with Airtraq video laryngoscope.The blood pressure and heart rate were recorded before induction(T 0),before intubation(T 1),immediately after intubation(T 2),first minute(T 3)and fifth minute(T 4)after intubation.The intubation time,Cormach-Lehane scale,external laryngeal press,use of magil forceps and the incidence of blood on laryngoscope were recorded. Results The systolic pressure and heart rate at T 2,T 3 and T 4 were significantly higher than T 1 in the group M(P<0.05),but no significant changes were found among T 2,T 3 and T 4 in the group A(P>0.05).The systolic pressure was significantly different between the two groups at T 2 and T 3(P<0.05).The heart rate was significantly different between the two groups at T 2,T 3 and T 4(P<0.05).The diastolic pressure was not significantly different between the two groups(P>0.05).The laryngoscope exposure scale in the group A was significantly superior to the group M(Z=-4.935,P=0.000).The intubation time in the group A(30.4±9.0)s was significantly less than that in the group M[(42.3±16.5)s,t=-3.468,P=0.000].Conclusion Nasotracheal intubation with Airtraq video laryngoscope has less influence on hemodynamics,shorter intubation time and easier performance as compared with Macintosh laryngoscope in patients with OSAHS.

关 键 词：Airtraq可视喉镜 MACINTOSH喉镜 经鼻气管插管 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R614[医药卫生—麻醉学]