非麻醉专业医师使用不同喉镜在气管插管教学中的应用研究  

Study on the Application of Different Laryngoscope in Endotracheal Intubation Teaching for Nonanesthesia Specialty Physicians

作　　者：冯龙 唐雨婷 邓溧 袁维秀 冯泽国 徐龙河 FENG Long;TANG Yuting;DENG Li;YUAN Weixiu;FENG Zeguo;XU Longhe(Department of Anesthesiology,Hainan Hospital of Chinese PLA General Hospital,Sanya Hainan 572000,China;Department of Pain,the First Medical Center of Chinese PLA General Hospital,Beijing 100086,China;Department of Anesthesiology,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]中国人民解放军总医院海南医院麻醉科,海南三亚572000 [2]中国人民解放军总医院第一医学中心疼痛科,北京100086 [3]中国人民解放军总医院第三医学中心麻醉科,北京100039

出　　处：《中国继续医学教育》2023年第15期111-115,共5页China Continuing Medical Education

基　　金：海南省自然科学基金项目(822MS198);海南省自然科学基金面上项目(821MS112)。

摘　　要：目的探讨对比Airtraq可视喉镜与普通喉镜在非麻醉专业医师学习气管插管教学中的研究。方法选择2019年6月—2022年3月到解放军总医院海南医院麻醉科临床轮转、实习、住培医师为研究对象,共48名。入科后先完成入科教育和了解认识常用气管插管工具和技术。按入科先后顺序,随机分为普通喉镜组(n=24)与视频喉镜组(n=24)。带教老师均为科室主治医师职称。选择马氏分级为Ⅰ~Ⅱ级的患者,各组医师采取对应插管工具给3例择期手术患者实施气管内插管。收集如下各项观察指标:置入喉镜难易程度(易、中、难);第1、第2、第3次气管插管成功率;是否可清晰看到声门解剖结构;看到声门可否顺利放入气管内导管;是否发生插管及拔管后相关并发症。结果所有医师均顺利完成气管插管操作。视频喉镜组较普通喉镜组简单易掌握,差异有统计学意义(P<0.001)。此外,视频喉镜组与普通喉镜组相比,前者可清晰看到声门解剖结构,差异有统计学意义(P=0.009)。看到声门能否顺利插入气管内导管组间相比,视频喉镜组较普通喉镜组成功率高,差异有统计学意义(P<0.001)。视频喉镜组第一次插管成功率较普通喉镜组高,差异有统计学意义(P=0.002)。组间插管过程及术后拔管后相关并发症差异无统计学意义(P>0.05)。结论非麻醉专业住院医师到麻醉科气管插管教学时,用Airtraq可视喉镜教学,易掌握,可清晰看到咽喉声门结构,第一次插管成功率更高。Objective To investigate the ease and the success rate of intubation between Airtraq visual laryngoscope and general laryngoscope in teaching tracheal intubation by nonprofessional anesthesia practitioners in anesthesiology,in training and rotating physicians.Methods A total of 48 physicians were selected for clinical rotation,internship and residency training in the department of anesthesiology of Hainan Hospital of PLA General Hospital from June 2019 to March 2022.After admission,admission education and understanding of the common endotracheal intubation tools and techniques were completed.The patients were randomized,in order of admission,to either plain laryngoscopy(n=24)or video laryngoscopy(n=24).The teaching teachers were all the attending physicians of the department.In patients with Mallampati grades I~II,the corresponding intubation tool was adopted by physicians in each group to administer endotracheal intubation to 3 patients undergoing elective surgery.Each observation index was collected as follows:difficulty level of placing laryngoscope(easy,medium,and difficult);1st,2nd,3rd tracheal intubation success rates;whether glottic anatomy is clearly visible;see if glottis can be placed smoothly into endotracheal tube;whether intubation and post extubation related complications occurred.Results All physicians completed the clinical operations smoothly.The placement of the laryngoscope in the visual laryngoscope group was simpler than that in the plain laryngoscope group,and the difference in the formation was statistically significant(P<0.001).In addition,glottic anatomy was completely and clearly visualized in the visual laryngoscope group compared with the plain laryngoscope group,and the difference was statistically significant(P=0.009).Seeing whether the glottis can be smoothly inserted into the endotracheal tube was associated with a higher success rate in the visible laryngoscope group than in the plain laryngoscope group,and the difference was statistically significant(P<0.001).The success rate of

关 键 词：气管插管 普通喉镜 Airtraq可视喉镜 教学 住培医师 实习医师 麻醉 

分 类 号：G642[文化科学—高等教育学]