改良UE可视喉镜声门暴露法在老年病人手术室外急救气管插管术中的应用  

Application of modified UE video laryngoscope glottis exposure method in emergency tracheal intubation outside the operating room for elderly patients

作　　者：李楠 刘洋 刘存明 杨春 丁正年 刘世江 LI Nan;LIU Yang;LIU Cun-ming;YANG Chun;DING Zheng-nian;LIU Shi-jiang(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围术期医学科,江苏省南京市210029

出　　处：《实用老年医学》2023年第10期1027-1030,共4页Practical Geriatrics

基　　金：中华医学会消化内镜学分会"人福科研基金"项目(CSDE012017120003);中国初级卫生保健基金会医路"格"新-液体治疗科研基金项目(YLGX-WS-2020012)。

摘　　要：目的改良UE可视喉镜声门暴露法和传统方法在老年病人急救气管插管时声门暴露时间和并发症情况比较。方法选择我院2021年1月至2022年1月急救气管插管老年病人128例,男90例,女38例,采用随机数表法将病人分为改良UE可视喉镜声门暴露组(M组)和传统暴露组(T组),每组64例。M组镜片先置入病人口腔后再与镜体结合;T组将组装好的喉镜直接置入病人口腔。记录声门暴露时间、声门暴露程度、完成插管时间、手指辅助暴露例数、咬合力等级以及口腔内软组织出血等并发症发生情况。结果2组声门暴露时间差异无统计学意义(P>0.05)。M组中病人口腔内组织出血发生率明显减少(P<0.01),尤其在病人咬合力Ⅰ级时(P=0.006)。结论改良UE可视喉镜声门暴露法并不增加声门暴露时间,并且能够降低老年病人行急救气管插管所导致的口腔内软组织出血的发生率。Objective To compare the glottis exposure time and complications between the modified UE video laryngoscope glottis exposure method and the traditional method during tracheal intubation in emergency elderly patients.Methods A total of 128 elderly patients receiving emergency tracheal intubation in our hospital from January 2021 to January 2022 were enrolled in this study,including 90 males and 38 females.The elderly patients were divided into modified group(group M)and traditional group(group T),with 64 cases in each group.For the patients in group M,the blade of the UE video laryngoscope was put into the patient’s mouth alone,and then the video laryngoscope was clamped into the blade.In group T,the UE video laryngoscope with the installed blade was placed directly into the patient’s mouth.The glottis exposure time,the degree of glottic visualization,the time to complete intubation,the number of finger-assisted exposure cases and the occlusal force level were recorded.The incidence of the complications such as bleeding of lips,gums,oral mucosa was recorded.Results There was no significant difference in the glottis exposure time between the two groups(P>0.05).The incidence rate of bleeding complications of lips,gums and oral mucosa in group M was significantly lower than that in group T(P<0.01),especially when the elderly patients had occlusal force of gradeⅠ(P=0.006).Conclusions The modified UE video laryngoscope glottis exposure method could reduce the intubation complications such as the bleeding of lips,gums and oral mucosain in the elderly patients,without increasing the glottis exposure time.

关 键 词：UE可视喉镜 气管插管 并发症 急救 老年人 

分 类 号：R605.97[医药卫生—急诊医学]