可视喉镜与可视硬管芯喉镜用于肥胖患者经口气管插管效果分析  

Comparison of video-laryngoscopy and rigid stylet video-laryngoscopy in orotracheal intubation in obese patients

作　　者：薛照静 李歆跃 张愿 仇焕容[1] 魏威[1] 薛富善 XUE Zhaojing;LI Xinyue;ZHANG Yuan;QIU Huanrong;WEI Wei;XUE Fushan(Department of Anesthesiology,Beijing Friendship Hospital of Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《中华实用诊断与治疗杂志》2020年第10期1043-1045,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：2018年贝朗麻醉科学研究基金资助项目(BBDF-2018-001)。

摘　　要：目的观察可视喉镜与可视硬管芯喉镜在肥胖患者经口气管插管中的应用效果,分析其可行性及临床疗效。方法80例气管插管行择期胃减容手术的肥胖患者,随机分为可视喉镜组和可视硬管芯喉镜组各40例。比较2组气管插管时间、首次气管插管成功率、二次气管插管成功率、三次气管插管成功率、气管插管总成功率和气管插管并发症发生情况。比较2组麻醉前(T0)、气管插管前(T1)、气管插管即刻(T2)、气管插管后1 min(T3)的收缩压和心率。结果可视喉镜组气管插管时间[(25.6±5.6)s]、首次气管插管成功率(95.0%)、二次气管插管成功率(2.5%)、三次气管插管成功率(2.5%)、气管插管总成功率(100.0%)和气管插管并发症发生率(10.0%)与可视硬管芯喉镜组[(28.7±8.8)s、90.0%、7.5%、2.5%、100.0%、5.0%]比较差异均无统计学意义(P>0.05);2组各时间点收缩压比较差异均无统计学意义(P>0.05),可视喉镜组T2时心率[(92.5±11.6)次/min]高于可视硬管芯喉镜组[(72.8±8.6)次/min](P<0.05);可视喉镜组T2时心率和收缩压高于T0、T1和T3时(P<0.05),T0、T1和T3时心率和收缩压两两比较差异均无统计学意义(P>0.05);可视硬管芯喉镜组T0、T1、T2、T3时心率和收缩压两两比较差异均无统计学意义(P>0.05)。结论可视喉镜与可视硬管芯喉镜均适用于肥胖患者气管插管,具有良好的声门暴露作用,应用可视硬管芯喉镜患者血流动力学更稳定。Objective To investigate the application of video-laryngoscopy and rigid stylet video-laryngoscopy in orotracheal intubation in obese patients and analyze the feasibility and clinical efficacy. Methods A total of 80 obese patients scheduled for stomach reduction surgery under orotracheal intubation were randomly and equally divided into video-laryngoscopy group and rigid stylet video-laryngoscopy group. The orotracheal intubation time, success rates and complications were compared between two groups. The systolic blood pressure and heart rate were compared between two groups before anesthesia(T0), before orotracheal intubation(T1), immediately after orotracheal intubation(T2), and 1 min after orotracheal intubation(T3). Results There were no significant differences in the orotracheal intubation time((25.6±5.6)s vs.(28.7±8.8)s), the first orotracheal intubation success rate(95.0% vs. 90.0%), the second orotracheal intubation success rate(2.5% vs. 7.5%), the third orotracheal intubation success rate(2.5% vs. 2.5%), total orotracheal intubation success rate(100.0% vs. 100.0%) and incidence of orotracheal intubation complication(10.0% vs. 5.0%) between video-laryngoscopy group and rigid stylet video-laryngoscopy group(P>0.05). The systolic blood pressure showed no significant differences at each time point between two groups(P>0.05). The heart rate was higher at T2 in video-laryngoscopy group((92.5±11.6) beats/min) than that in rigid stylet video-laryngoscopy group((72.8±11.6) beats/min)(P<0.05). In video-laryngoscopy group, the heart rate and systolic blood pressure were higher at T2 than those at T0, T1 and T3(P<0.05), and showed no significant differences at T0, T1 and T3 in multiple comparison(P>0.05). In rigid stylet video-laryngoscopy group, the heart rate and systolic blood pressure at T0, T1, T2 and T3 showed no significant differences in multiple comparison(P>0.05). Conclusion Both video-laryngoscopy and rigid stylet video-laryngoscopy are suitable for orotracheal intubation in obese patients, with good

关 键 词：气管插管 可视喉镜 可视硬管芯喉镜 肥胖 

分 类 号：R614[医药卫生—麻醉学]