可调节气管插管SEEKflex套件在肥胖减重术呼吸道管理中的应用效果及对血流动力学的影响  

Application effects of the adjustable tracheal intubation SEEKflex kit on airway management during obesity bariatric surgery and its impact on hemodynamics

作　　者：张莹[1] 金小春 尹述洲[1] 张有涛[2] ZHANG Ying;JIN Xiaochun;YIN Shuzhou;ZHANG Youtao(Department of Anesthesiology,the Affiliated Suzhou Jiulong Hospital,Shanghai Jiaotong University,Suzhou,Jiangsu 215028,China;Department of Clinical Laboratory,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)

机构地区：[1]上海交通大学附属苏州九龙医院麻醉科,江苏苏州215028 [2]苏州大学附属第一医院检验科,江苏苏州215006

出　　处：《检验医学与临床》2025年第4期506-511,共6页Laboratory Medicine and Clinic

基　　金：江苏省苏州工业园区培育科研项目(JL201807)。

摘　　要：目的探讨可调节气管插管SEEKflex套件(SEEKflex)在肥胖减重术患者呼吸道管理中的应用效果及对血流动力学的影响。方法选择2021年10月至2022年10月上海交通大学附属苏州九龙医院收治的80例进行肥胖减重术治疗的肥胖合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者作为研究对象,采用随机数字表法将患者分为观察组、对照组,每组40例。对照组术中全身麻醉时采用传统导管管芯塑形后进行气管插管;观察组术中全身麻醉时采用SEEKflex引导导管进行气管插管。比较2组患者不同时间点心率、收缩压、舒张压、平均动脉压。观察2组患者一次插管成功率、插管耗时及不良反应发生情况。结果重复测量方差分析结果显示,2组心率、收缩压、舒张压及平均动脉压存在组间效应、时间效应和交互效应(P<0.001)。多变量方差分析结果显示,观察组插管后即刻、插管后30 s、插管后1 min心率、收缩压、舒张压及平均动脉压均低于对照组(P<0.05)。观察组一次插管成功率高于对照组(97.5%vs.85.0%),插管耗时长于对照组[(6.71±1.28)min vs.(5.26±1.13)min],不良反应发生率明显低于对照组(5.0%vs.25.0%),差异均有统计学意义(P<0.05)。结论使用SEEKflex对实施肥胖减重术的肥胖合并OSAHS患者呼吸道管理的效果较好,患者血流动力学指标较为稳定,插管成功率高,且不良反应较少,值得临床应用及推广。Objective To investigate the effect of the adjustable tracheal intubation SEEKflex Kit(SEEKflex)on airway management and its impact on hemodynamics in patients undergoing obesity bariatric surgery.Methods A total of 80 obescity patients combined with obstructive sleep apnea-hypopnea syndrome(OSAHS)who underwent obesity bariatric surgery at the Affiliated Suzhou Jiulong Hospital,Shanghai Jiaotong University from October 2021 to October 2022 were selected for this study.The patients were assigned to the observation group and the control group,with 40 patients in each group,using a random number table.In the control group,traditional endotracheal intubation with a catheter-shaped stylet was performed under general anesthesia.In the observation group,intubation was performed using the SEEKflex-guided catheter under general anesthesia.The heart rate,systolic blood pressure,diastolic blood pressure and mean arterial pressure at different time points were compared between the two groups.The success rate of intubation on the first attempt,intubation time and the occurrence of adverse reactions were observed and compared between the two groups.Results The results of repeated measures analysis of variance showed that there were group effects,time effects and interaction effects on heart rate,systolic blood pressure,diastolic blood pressure and mean arterial pressure between the two groups(P<0.001).Multivariate analysis of variance revealed that heart rate,systolic blood pressure,diastolic blood pressure and mean arterial pressure immediately after intubation,30 s after intubation,and 1 min after intubation in the observation group were all significantly lower than those in the control group(P<0.05).The success rate of intubation on the first attempt in the observation group was higher than that in the control group(97.5%vs.85.0%),the intubation time was longer that in the control group[(6.71±1.28)min vs.(5.26±1.13)min],the incidence of adverse reactions in the observation group was significantly lower than that in the co

关 键 词：肥胖减重术 呼吸道管理 气管插管 全身麻醉 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R614.2[医药卫生—麻醉学] R656.61[医药卫生—外科学]