三级防护下不同气管插管方式比较  

Comparison of Different Tracheal Intubation Methods Under Three-Level Protection

作　　者：潘鹏 袁林芳 俞灵 张代玲[1] 陆培春 PAN Peng;YUAN Linfang;YU Ling(Department of Anesthesiology,Traditional Chinese Medicine Hospital of Kunshan City,Jiangsu Province 215300)

机构地区：[1]江苏省昆山市中医医院麻醉科,215300

出　　处：《医学理论与实践》2021年第17期2949-2952,共4页The Journal of Medical Theory and Practice

基　　金：昆山市级科技专项(KJJKJZXSF2020018)。

摘　　要：目的:比较普通喉镜、可视喉镜和可视光棒在三级防护下气管插管的临床效果。方法:将90例择期行气管插管全麻手术的患者采用随机数字表法分为3组,普通喉镜组(A组)、可视喉镜组(B组)、可视光棒组(C组),每组30例。麻醉医生在三级防护下对患者进行气管插管,观察比较3组患者声门暴露时间、插管时间、首次插管成功率,插管时患者口部到麻醉医生防护面屏中心距离(口屏距离);诱导前5min(T_(0))、诱导后即刻(T_(1))、插管后即刻(T_(2))、插管后3min(T_(3))时的心率(HR)和平均动脉压(MAP);记录需要助手协助插管的例数,麻醉医生疲劳评分(VAS),插管后并发症发生情况。结果:B组声门暴露时间、插管时间与A组和C组比较明显缩短(P<0.01),B组和C组首次插管成功率高于A组(P<0.05),B组和C组的口屏距离较A组明显增加(P<0.01)。3组T_(2)时刻HR和MAP较T_(0)时刻均升高(P<0.05),T_(2)时刻C组的HR和MAP明显低于A组和B组(P<0.05)。B组和C组需要助手协助的例数、插管后并发症以及VAS评分较A组均下降(P<0.05)。结论:在三级防护下进行气管插管,可视喉镜和可视光棒提高插管成功率,减少插管并发症,增加患者口腔与防护面屏的距离,降低了麻醉医生暴露的风险。Objective:To compare the clinical effects of direct laryngoscope,videolaryngoscope and visible light wand in tracheal intubation under three-level protection.Methods:90 patients who underwent general anesthesia for tracheal intubation were randomly divided into 3 groups:direct laryngoscope group(group A),video laryngoscope group(group B),and visible light wand group(group C),30 cases in each group.The anesthesiologist performed tracheal intubation under three-level protection.The time of exposing glottis and tracheal intubation were recorded.The success rate of first intubation and the distance between the patient’s mouth and the center of the anesthesiologist’s protective screens during intubation(mouth-to-screen distance)were detected.Heart rate(HR)and mean arterial pressure(MAP)at 5 minutes before induction(T_(0)),immediately after induction(T_(1)),immediately after intubation(T_(2))and 3 minutes after intubation(T_(3))were recorded.The number of cases requiring intubation assistance,anesthesiologist’s fatigue score(VAS)and the occurrence of post-intubation complications were recorded as well.Results:The time of exposing glottis and tracheal intubation in group B were significantly shorter than those in group A and group C(P<0.01).The success rate of first intubation in group B and group C was higher than that in group A(P<0.05).The mouth-to-screen distance in group B and group C was significantly increased compared with group A(P<0.01).The HR and MAP in the three groups at T_(2)were higher than those at T_(0)(P<0.05),the HR and MAP in group C at T_(2)were significantly lower than those in group A and group B(P<0.05).The number of cases requiring intubation assistance,post-intubation complications and VAS score in group B and group C were lower than those in group A(P<0.05).Conclusion:Tracheal intubation under three-level protection,videolaryngoscope and visible light wand improve the success rate of intubation,reduce intubation complications,increase the distance between the patient’s mouth and the pr

关 键 词：新型冠状病毒肺炎 三级防护 气管插管 喉镜 

分 类 号：R614[医药卫生—麻醉学]