不同塑形角度导管用于McGrath-5型视频喉镜下潜在困难气管插管患者插管效果中的对比研究  

A comparative study on the effect of catheters with different shaping angles in patients with potentially difficult tracheal intubation under McGrath-5 video laryngoscope

作　　者：严峰 李军[3] 王浩杰[2] YAN Feng;LI Jun;WANG Haojie(Department of Anesthesiology,Ningbo Hospital of Traditional Chinese Medicine,Ningbo 315000,China;Department of Anesthesiology,Yuyao People′s Hospital in Zhejiang Province,Yuyao 315400,China;Department of Anesthesiology,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]宁波市中医院麻醉科,浙江宁波315000 [2]浙江省余姚市人民医院麻醉科,浙江余姚315400 [3]温州医科大学附属二院麻醉科,浙江温州325027

出　　处：《中国现代医生》2022年第3期137-141,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2017ZH014);浙江省宁波市科技项目(2017C50071)。

摘　　要：目的比较不同塑形角度导管用于McGrath-5型视频喉镜引导下在潜在困难气管插管患者中的应用效果。方法选取2016年10月至2019年10月余姚市人民医院具有潜在困难气管插管患者200例,按随机数字表法分为A、B、C、D、E组,每组各40例,分别用导管前端塑形30°、45°、60°、75°、90°后再通过McGrath-5型视频喉镜引导行气管插管;观察并比较5个塑形角度下各组一般情况、困难气道评估指标、气管插管难度及气管插管并发症发生情况。结果五组术前一般资料、困难气道病史、BMI、鼾症、下颌骨水平长度评分、Mallampati分级评分、上下切牙距离、颈围、甲颏间距、头后仰角度评分等气道评估指标比较,差异均无统计学意义(P>0.05);插管难度1分的例数D组37例,多于其余四组;首次导管对准声门成功率D组为97.5%明显高于其余四组(P<0.05);D组一次插管时间大于60 s 2例,明显少于其余各组,差异有统计学意义(P<0.05);C、D两组气管导管沾血发生率分别为2.6%、5.0%,明显低于其余三组,差异有统计学意义(P<0.05),五组术后咽痛发生率比较,C、D两组分别为2.6%、2.5%,明显少于其余三组,差异有统计学意义(P<0.05)。结论气管导管前端塑形成75°左右时,对于潜在困难气管插管患者的气管插管成功率高、用时最短、相关并发症最少。Objective To compare the effect of different shaping angle catheters in patients with potentially difficult tracheal intubation under the guidance of McGrath-5 video laryngoscope.Methods A total of 200 patients with potentially difficult tracheal intubation from Yuyao People′s Hospital from October 2016 to October 2019 were selected.They were divided into groups A,B,C,D,and E according to a random number table,with 40 cases in each group.The front end was shaped 30°,45°,60°,75°,90°,and then tracheal intubation was guided under McGrath-5 video laryngoscope.The general condition and difficult airway evaluation indicators,the difficulty of endotracheal intubation,and the occurrence of complications of endotracheal intubation in each group under five shaping angles were observed and compared.The tip of the catheter was shaped 30°,45°,60°,75°,90°,and then the tracheal intubation was guided through the McGrath-5 video laryngoscope.Results The pairwise comparison of indicators in general preoperative information,BMI,snoring,mandible horizontal length score,Mallampati grading score,distance between upper and lower incisors,neck circumference,chin spacing,and head back angle score among five groups was not statistically significant(P>0.05).The number of cases with intubation difficulty of 1 point was 37 cases in group D,which was more than the other four groups.The success rate of one-time catheterization to glottis in group D was 97.5%,which was significantly higher than those in the other four groups(P<0.05).Two cases in group D had an intubation time longer than 60 seconds,which was significantly less than the other groups,and the difference was statistically significant(P<0.05).The incidence of tracheal duct hemorrhage in groups C and D was 2.6%and 5.0%,respectively,which was significantly lower than those of the other three groups(P<0.05).The incidence of postoperative sore throat in group C and group D was 2.6%and 2.5%,which was significantly lower than the other three groups,and the difference was stati

关 键 词：McGrath-5型视频喉镜 气管插管 导管芯 塑形角度 

分 类 号：R614[医药卫生—麻醉学] R768[医药卫生—外科学]