初学者使用环状弯曲与管芯塑形气管导管在预期非困难气道患者中的效果比较  

Comparison of the effect of using ring-shaped bending tubes and style bending tubes by novices in patients with expected normal airway

作　　者：刘冬梅 莫怀忠 易强林 LIU Dongmei;MO Huaizhong;YI Qianglin(Department of Anesthesiology,the Affiliated Cancer Hospital of Guizhou Medical University,Guiyang 550000,China)

机构地区：[1]贵州医科大学附属肿瘤医院麻醉科,贵阳市550000 [2]贵州医科大学附属医院麻醉科

出　　处：《临床麻醉学杂志》2022年第8期841-845,共5页Journal of Clinical Anesthesiology

摘　　要：目的 比较初学者使用环状弯曲与管芯塑形气管导管在预期非困难气道患者中气管插管的效果。方法 选择择期行全麻下气管插管的预期非困难气道患者126例,男60例,女66例,年龄18~64岁,BMI 18~30 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:环状弯曲组(RB组)和管芯塑形组(SB组),每组63例。麻醉诱导后由初学者实施气管插管。记录Cormack-Lehane分级(C-L分级)、喉外辅助按压情况、插管时间、插管次数、插管难易程度评分。记录麻醉诱导前基础值、诱导后、气管插管即刻、插管后1、5 min的HR、MAP及插管时并发症发生情况。记录术后2、24 h咽痛及声音嘶哑的发生情况。结果 两组C-L分级、喉外辅助按压比例、插管时间、插管次数、插管难易程度差异无统计学意义。RB组插管即刻及插管后1 min HR明显慢于SB组,MAP明显低于SB组(P<0.05)。RB组术后2、24 h咽痛及声音嘶哑发生率明显低于SB组(P<0.05)。结论 初学者在对预期非困难气道患者实施气管插管时,使用环状弯曲气管导管的插管时间及插管次数与管芯塑形气管导管相似,但不良反应发生率更低。Objective To compare the effect of endotracheal intubation by novices using ring-shaped bending versus style bengding in patients with expected normal airways.Methods A total of 126 expected normal airway patients underwent selective surgery of tracheal intubation under general anesthesia,60 males and 66 females,aged 18-64 years,BMI 18-30 kg/m^(2),ASA physiccal status Ⅰ or Ⅱ,were randomly divided into two groups:ring-shaped bending group(group RB) and style bending group(group SB),63 patients in each group.Endotracheal intubation was performed by novices after anesthesia induction.Cormack-Lehane glottic view grade,usage of external laryngeal manipulation,time of intubation,the number of intubations,and intubation difficulty score were recorded.The HR and MAP of patients were recorded immediately before anesthesia induction,immediately after anesthesia induction,immediately after endotracheal intubation,1 minute and 5 minutes after endotracheal intubation.Complications during intubation were recorded.The incidence of pharyngodynia and hoarseness were recorded 2 and 24 hours after the operation.Results There was no statistically significant differences in Cormack-Lehane glottic view grade,usage of external laryngeal manipulation,time of intubation,the number of intubations,and intubation difficulty score between two groups.HR and MAP immediately after intubation and 1 minute after intubation in group RB were significantly lower than that in group SB(P < 0.05).The incidence of pharyngodynia and hoarseness 2 and 24 hours after the operation in group RB were significantly lower than that in group SB(P < 0.05).Conclusion When novices perform endotracheal intubation in patients with an expected normal airway,the intubation time and the number of intubations using ring-shaped bending tubes are similar to those of using style bending tubes,but with a lower incidence of adverse reaction.

关 键 词：气管插管 初学者 气管导管 非困难气道 不良反应 

分 类 号：R614[医药卫生—麻醉学]