支撑喉镜引导气管插管在困难气道患者中的应用效果  

Application effect of suspension laryngoscope-guided tracheal intubation in patients with difficult airway

作　　者：班正锋[1] 彭兖莱[1] 何艺[2] 陈峻[2] 零兴勤[1] 梁华[1] BAN Zheng-feng;PENG Yan-lai;HE Yi;CHEN Jun;LING Xing-qin;LIANG Hua(Department of Otolaryngology,Minzu Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,Guangxi,China;Department of Anesthesiology,Minzu Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,Guangxi,China)

机构地区：[1]广西壮族自治区民族医院耳鼻喉科,广西南宁市530001 [2]广西壮族自治区民族医院麻醉科,广西南宁市530001

出　　处：《广西医学》2022年第15期1734-1738,共5页Guangxi Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016153)。

摘　　要：目的 观察支撑喉镜引导气管插管在困难气道患者中的应用效果。方法 选择择期行全身麻醉手术的86例困难气道患者,随机分为纤维支气管镜(简称纤支镜)组和支撑喉镜组,各43例。麻醉诱导后分别在纤支镜或支撑喉镜的引导下进行气管插管。比较两组患者声门暴露情况、一次插管成功率、插管时间、插管并发症发生率,以及患者不同时间点生命体征相关指标的变化。结果 两组患者的声门暴露情况、一次插管成功率、插管并发症发生率比较,差异均无统计学意义(均P>0.05),但支撑喉镜组插管时间短于纤支镜组(P<0.05)。两组的收缩压、舒张压及心率均有随时间变化的趋势(均P<0.05),但两组患者不同时间点的收缩压、舒张压及心率比较,差异均无统计学意义(均P>0.05)。结论 支撑喉镜引导气管插管时声门暴露情况、一次插管成功率、插管并发症发生率及对患者生命体征的影响与纤支镜引导气管插管相当,但其插管时间更短,可安全、有效地应用于无支撑喉镜手术禁忌的困难气道插管患者。Objective To observe the application effect of suspension laryngoscope-guided tracheal intubation in patients with difficult airway.Methods Eighty-six patients with difficult airway undergoing elective surgery under general anesthesia were selected and randomly assigned to bronchofiberscope group or suspension laryngoscope group,with 43 cases in each group.After induction of anesthesia,tracheal intubation was guided by bronchofiberscope or suspension laryngoscope,respectively.The glottis exposure,success rate of one-time intubation,intubation time,incidence rate of intubation complications,and the changes of indices related to vital signs at various time points were compared between the two groups.Results There were no statistically significant differences in the glottis exposure,success rate of one-time intubation,and incidence rate of intubation complications between the two groups(all P>0.05);however,the intubation time in the suspension laryngoscope group was shorter than that in the bronchofiberscope group(P0.05).Conclusion The glottis exposure,success rate of one-time intubation,incidence rate of intubation complications,and effects on patients′ vital signs when using suspension laryngoscope-guided tracheal intubation are comparable to those when using bronchofiberscope-guided tracheal intubation;however,the intubation time is shorter,which can be a safe and effective application to the patients with difficult airway intubation but without suspension laryngoscope operative contraindication.

关 键 词：困难气道 气管插管 支撑喉镜 纤维支气管镜 全身麻醉 

分 类 号：R76[医药卫生—耳鼻咽喉科]