摘要
目的 在急诊应用TruviewTM EVO2（R）光学喉镜和普通喉镜进行紧急气管插管的对比,评价TruviewTM EVO2（R）光学喉镜在急诊临床应用的优势.方法 选择2009年2月至2009年5月期间在北京朝阳医院急诊科就诊的36例需要进行紧急气管插管的患者,随机分为两组：R组应用普通喉镜进行气管插管,T组应用TruviewTM EVO2（R）光学喉镜进行气管插管.记录气道声门暴露C/L（Cormack ＆ Lehane）分级;气管插管过程中SpO2下降的最低值及成功插管所用时间;IDS评分（intubation difficulty scale score,困难气管插管记分量表）及经气管插管后患者的并发症.结果 T组建立有效气道的时间（22.73±7.66）s与R组（19.91±8.03）s相比差异无统计学意义（P＞0.05）;T组的声门暴露情况明显优于R组;T组IDS评分（0.33±0.49）分明显低于R组（4.11±0.90）分（P＜0.01）;T组插管过程中SpO2平均值（98.87±0.74）%明显高于R组（91.45±4.86）%（P＜0.01）;T组插管后并发症少于R组.结论 TruviewTM EVO2（R）光学喉镜在急诊气道处理中,能够很好地暴露声门,明显降低C/L分级,降低气管插管的困难程度.其特殊的供氧装置能够在气管插管过程中维持患者的SpO2于较高水平,并且明显减少了并发症的发生,从而给急诊气管插管,尤其是困难气管插管提供了良好的帮助.
Objective To evaluate the effectiveness and advantage of the TruviewTM EVO2（R） optical laryngoscope in comparison with the commonly used laryngoscope for the endotracheal intubation in patients in the emergency setting. Method Thirty-six patients in need for emergency endotracheal intubation in our hospital from February to May 2009 were randomly assigned to give intubation by using a TruviewTM EVO2（R） optical laryngoscope （T group） or a commonly used laryngoscope（R group）. Cormack and Lehane laryngoscope grade （the degree of exposure of glottis by using laryngoscope）, IDS （Intubation Difficulty Scale） score, the time taken for successful intubation, lowest SpO2 and the complication during intubation were essential factors for comparison between two groups. Results Our data showed that there was no difference in duration of the successful endotracheal intubation attempts between these two groups （respectively 22.73 ± 7.66 s and 19.91 ± 8.03 s, P 〉 0. 05）. However, the glottis exposure condition was significantly improved with TruviewTM EVO2（R） optical laryngoscope （P 〈 0.01）. The average IDS score for patients in T group was 0.33 ± 0.49, which is much lower than those in the R group （4.11± 0.90, P 〈 0.01）. In addition, the average SpO2 value measured in T group during the intubation operation was significantly higher than that in R group （98.87±0.74% and 91.45 ±4.86% respectively, P 〈0.01） and there was less complication observed in patients of T group. Conclusions Using TruviewTM EVO2（R） optical laryngoscope for emergency endotracheal intubation could help to expose the glottis in an ideal view, predominately lower the C/L grade and thus decrease the difficulty in intubation for clinicians. Its specially designed oxygen supplier allows the SpO2 to be maintained at a high level during the operation as well as reduce the incidence of complication. It is therefore extremely useful for emergency tracheal intubation, particularly a difficulty intubation situation.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2011年第1期70-73,共4页
Chinese Journal of Emergency Medicine
