摘要
目的观察比较GlideScope视频喉镜和普通Macintosh直接喉镜经口气管插管的临床效果。方法选择60例ASA分级Ⅰ-Ⅱ级,拟经口气管插管全麻下择期手术的患者,随机分为GlideScope视频喉镜组(G组,n=30)和Macintosh直接喉镜组(M组,n=30)。麻醉诱导后,观察并记录两组基础值、诱导后、声门暴露即刻、气管插管即刻和插管成功后1、2、5 min时的心率和无创血压,同时记录插管时声门暴露程度(Cormark-Lehane分级)、插管时间、一次性插管成功率和插管并发症(如咽痛、声嘶等)。结果 G组在声门暴露时的心率和无创血压升高程度显著小于M组;G组心率和无创血压最大值出现在插管时,而M组最大值多出现在声门暴露时。Cormark-Lehane分级G组(Ⅲ1例)明显比M组(Ⅲ6例)低(P<0.05);G组插管时间(29.1±2.6)s与M组(31.4±4.3)s差异无统计学意义(P>0.05);G组一次性插管成功率100%,M组为86.7%;G组未出现插管并发症,M组有3例出现咽痛,均自行缓解。结论与Macintosh型直接喉镜相比,GlideScope视频喉镜可以明显改善声门暴露,降低插管难度,提高插管成功率,减少并发症,但并不能减轻气管插管的应激反应。
Objective To observe and compare the clinical application of orotracheal intubation with GlideScope videolaryngoscope and Macintosh direct laryngoscope.Methods Sixty patients with ASA physical status fromⅠ toⅡ,scheduled for elected operation under general anesthesia requiring orotracheal intubation,were randomly divided into group G and group M with 30 patients in each group.After a standard intravenous anesthetic induction operated,noninvasive blood pressures（NBP） and heart rate（HR） were recorded and analyzed before and after anesthetic induction,at intubation,1 min,2 min and 5 min after intubation,respectively.Cormark-Lehane grade,orotracheal intubation time,onetime success rate and intubation complications such as pharyngodynia and hoarse voice were also recorded.Results The rise of NBP and HR in M group were significantly higher than those in G group at glottic exposure（P0.05）.The highest of NBP and HR in G group were appeared at tracheal intubation,while M group was at glottic exposure.G group（Ⅲ 1 person） achieved better glottic exposure view than M group（Ⅲ 6 persons）（P0.05）.There was no significant diference of the intubation time between the two groups（P0.05）.The success rate of orotracheal intubation on the first attempt was 100% in group G and 86.7% in group M.There were 3 patients had pharyngodynia in group M,while nobody in group G.Conclusion GlideScope videolaryngoscope,compared with Macintosh direct laryngoscope in the anesthetic orotracheal intubation,could obviously receive better glottic exposure view,decrease the difficulty of intubation and less complications,but could not reduce hemodynamic responses.
出处
《安徽医学》
2011年第2期179-181,共3页
Anhui Medical Journal
