可视喉镜与直接喉镜在全麻气管插管中的细菌学对比研究  

Comparative study of bacteriological results between visual laryngoscope and direct laryngoscope in tracheal intubation under general anesthesia

作　　者：殷茂静 韩春莉 王丽 李凯 胡芸 刘琼 袁文常 黄建成 Yin Maojing;Han Chunli;Wang Li;Li Kai;Hu Yun;Liu Qiong;Yuan Wenchang;Huang Jiancheng(Department of Anesthesiology,General Hospital of Xinjiang Military Region,Urumqi 830002,China;Whole Army Clinical Laboratory Diagnosis Center,General Hospital of Xinjiang Military Region,Urumqi 830002,China;KingMed School of Laboratory Medicine,Guangzhou Medical University,Guangzhou 510182,China)

机构地区：[1]新疆军区总医院麻醉科,乌鲁木齐830002 [2]新疆军区总医院全军临床检验诊断中心,乌鲁木齐830002 [3]广州医科大学金域检验学院,广州510182

出　　处：《国际麻醉学与复苏杂志》2024年第2期160-163,共4页International Journal of Anesthesiology and Resuscitation

基　　金：广东省自然科学基金(2021A1515011360)。

摘　　要：目的比较可视喉镜和直接喉镜在全麻经口气管插管后细菌学检测结果,为插管方式的选择提供依据。方法选取2020年5月到2021年4月择期行全麻手术的患者90例,按随机数字表法分为可视喉镜组(试验组)和直接喉镜组(对照组),每组45例。试验组用可视喉镜暴露声门,在显示屏引导下插入气管导管;对照组在充分暴露声门的情况下,用直接喉镜插管。观察并记录两组患者气管导管尖端菌株的种类、数量及术后1周肺部感染的发生情况。结果试验组术后1周有3例(6.7%)发生肺部感染,对照组术后1周有1例(2.2%)发生肺部感染,两组差异无统计学意义(P>0.05);两组患者气管导管尖端菌株的种类略有差异,试验组菌株数为61株,占42.36%,对照组菌株数为83株,占57.64%,两组患者菌株占比差异无统计学意义(P>0.05)。结论在全麻经口插管时,使用可视喉镜与直接喉镜相比,没有增加感染的风险。Objective To compare the bacteriological results between visual laryngoscope and direct laryngoscope after oral tube intubation under general anesthesia,in order to provide evidence for the selection of intubation methods.Methods A total of 90 patients who were scheduled for surgery under general anesthesia from May 2020 to April 2021 were selected.According to the random number table method,they were divided into two groups(n=45):a visual laryngoscope group(an experimental group)and a direct laryngoscope group(a control group).For the experimental group,the glottis was exposed using a visual laryngoscope,followed by insertion of the endotracheal tube under the guidance of the screen,while patients in the control group was intubated using a direct laryngoscope with the glottis fully exposed.Both groups were compared for the types and number of bacterial strains at the tip of endotracheal tubes and the pulmonary infection incidence at postoperative 1 week.Results There were three patients(6.7%)in the experimental group and one patient(2.2%)in the control group who presented pulmonary infection at postoperative 1 week,without statistical differences between the two groups(P>0.05).Slight differences were seen in the types of bacterial strains on the endotracheal tube tips between the two groups.Furthermore,there were 61 strains(42.36%)in the experimental group,and 83 strains(57.64%)in the control group,without statistical differences between the two groups(P>0.05).Conclusion During oral tube intubation under general anesthesia,visual laryngoscope does not increase the risk of infection,compared with direct laryngoscope.

关 键 词：麻醉 全身 可视喉镜 直接喉镜 肺 感染 细菌学 

分 类 号：R614[医药卫生—麻醉学]