纤维支气管镜经口气管插管专用可视喉镜在困难气道患者甲状腺手术的应用  

Application of visual laryngoscope designed for branchofiberoscope for oral intubation in patients with difficult airway undergoing thyroid surgery

作　　者：张云仙[1] 邓燕忠 黄政坤[1] ZHANG Yunxian;DENG Yanzhong;HUANG Zhengkun(Department of Anesthesiology, Jiangyuan Hospital, Institute of Atomic Medicine of Jiangsu Province,Wuxi 214063,CHINA)

机构地区：[1]江苏省原子医学研究所附属江原医院麻醉科,江苏无锡214063 [2]无锡市惠山区人民医院麻醉科,江苏无锡214063

出　　处：《江苏医药》2019年第3期280-282,共3页Jiangsu Medical Journal

摘　　要：目的观察纤维支气管镜经口气管插管专用可视喉镜在困难气道患者甲状腺手术的的应用效果。方法选择拟行甲状腺手术的困难气道患者48例,且均实施清醒气管插管全身麻醉,MallampatiⅢ或Ⅳ级。随机均分为两组:A组采用纤维支气管镜经口气管插管专用可视喉镜行气管插管;B组采用常规纤维支气管镜行气管插管。比较两组一次插管成功率、插管总时间和麻醉诱导前(T1)、诱导后即刻(T2)、插管时(T3)以及插管后3 min(T4)时的血压和心率变化,记录插管并发症发生情况。结果 A组的一次插管成功率高于B组(95.8%vs.75.0%)(P<0.05)。两组T3、T4时血压和心率均较T1时升高(P<0.05),但组间比较无统计学差异(P>0.05)。A组黏膜损伤发生率低于B组[4.2%(1/24) vs.16.7%(4/24)](P<0.05),A组咽喉痛发生率低于B组[4.2%(1/24) vs.12.5%(3/24)](P<0.05)。结论与常规纤维支气管镜插管比较,采用纤维支气管镜经口气管插管专用可视喉镜用于困难气道患者甲状腺手术可提高一次插管成功率,减少插管相关并发症的发生。Objective To observe the efficiency of visual laryngoscope(VLS) designed for branchofiberoscope(BFS) for conscious oral intubation in the patients with difficult airway undergoing thyroid surgery under general anesthesia.Methods Forty-eight patients with difficult airway(Mallampati level Ⅲ-Ⅳ) undergoing thyroid surgery were assigned into two groups with 24 cases each.The patients in group A were intubated by VLS designed for BFS for oral intubation and those in group B were intubated by conventional BFS.The success rate of tracheal intubation by one-time attempt and intubation time were calculated.The changes of blood pressure and heart rate were recorded before anesthesia induction(T1),soon after induction(T2),during intubation(T3) and at 3 minutes after intubation(T4) were compared between two groups.The incidence of intubation-related complications of two groups was observed.Results The success rate of tracheal intubation by one-time attempt was higher in group A than that in group B(96.1% vs.75.3%)(P<0.05).The blood pressure and heart rate of both groups were higher at T3 and T4 than those at T1(P<0.05),which were not significantly different between groups of A and B(P>0.05).The incidence rates of mucosal injury and pharyngalgia were lower in group A than those in group B(4.2% vs.16.7% and 4.2% vs. 12.5%)(P<0.05).Conclusion Compared to endotracheal intubation using conventional BFS,application of VLS designed for BFS can increase the success rate of intubation by one-time attempt and decrease the intubation-related complications in the patients with difficult airway.

关 键 词：可视喉镜 困难气道 甲状腺手术 纤维支气管镜 

分 类 号：R614[医药卫生—麻醉学]