不同塑形角度导管对初学者可视喉镜下行气管插管的效果  

Effect of Different Shaping Angles on Endotracheal Intubation under Visual Laryngoscope for Beginners

作　　者：屈启才[1] 杨柳[1] 余慧[1] 张宁丽 胡平[1] 杨健 QU Qicai;YANG Liu;YU Hui;ZHANG Ningli;HU Ping;YANG Jian(Dept.of Anesthesiology,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院麻醉科,云南昆明650101

出　　处：《昆明医科大学学报》2023年第12期171-176,共6页Journal of Kunming Medical University

基　　金：昆明医科大学第二附属医院院内基金资助项目(2020yk12)。

摘　　要：目的比较4种不同塑形角度导管对初学者气管插管成功率及术后咽部并发症的影响。方法选取全麻下行腹腔镜胆囊切除的患者160例,ASA分级Ⅰ~Ⅱ级,无困难气道病史,根据导管形态及尖端塑形角度随机分为4组:35°蕉形弯管组(A组),50°蕉形弯管组(B组),35°直管组(C组),50°直管组(D组),每组40例。全麻诱导后,初学者采用可视喉镜进行气管插管。记录4组患者喉镜暴露分级(Cormack-Lehane分级)、喉外按压情况、插管一次成功率及插管时间;记录麻醉诱导前(T_(0))、麻醉诱导药物注射结束(T_(1))、插管即刻(T_(2))、插管后1min(T_(3))患者的SPO_(2)、HR、MAP;随访拔管后即刻及术后24 h咽部疼痛及声音嘶哑发生率。结果4组患者各时间点Cormack-Lehane分级、HR、MAP比较,差异无统计学意义(P>0.05)。B组和D组需要喉外按压的例数、插管时间、插管1次成功率、术后即刻咽痛、术后即刻声音嘶哑发生率均低于A组和C组,差异有统计学意义(P<0.05)。结论使用可视喉镜进行气管插管时,50°蕉形弯管及50°直管可以缩短插管时间,术后并发症少,无明显血流动力学波动。Objective To compare the effects of 4 different shaping angle tubes on the success rate of tracheal intubation and postoperative pharyngeal complications among anesthetic beginners.Methods 160 patients who underwent laparoscopic cholecystectomy under general anesthesia,with ASA classification I to II,no history of difficult airway,were randomly divided into 4 groups according to the catheter shape and tip shaping angle:35°banana-shaped elbow group(A Group),50°banana-shaped bent pipe group(Group B),35°straight pipe group(Group C),50°straight pipe group(Group D),with 40 cases in each group.After induction of general anesthesia,tracheal intubation is performed using a video laryngoscope.The Cormack-Lehane grade of laryngoscope exposure,external laryngeal compression,one-time success rate of intubation and intubation time were recorded.SPO_(2),HR and MAP were recorded before anesthesia induction(T_(0)),at the end of anesthesia induction drug injection(T_(1)),immediately after intubation(T_(2))and 1min after intubation(T_(3)).The incidence of pharyngeal pain and hoarseness immediately after extubation and 24 hours after operation were followed up.Results There were no statistically significant differences in Cormack-Lehane classification,HR,and MAP among the four groups of patients at each time point(P>0.05).The number of cases requiring external laryngeal compression,intubation time,first-time intubation success rate,immediate postoperative sore throat,and immediate postoperative hoarseness rates in Groups B and D were all lower than those in Groups A and C,and the differences were statistically significant(P<0.05).Conclusion When using video laryngoscope for tracheal intubation,50°banana-shaped curved tube and 50°straight tube can shorten the intubation time,reduce postoperative complications,and have no obvious hemodynamic fluctuations.

关 键 词：气管插管 可视喉镜 气管导管塑形 咽部并发症 

分 类 号：R614.2[医药卫生—麻醉学]