摘要
目的观察McCoy喉镜在困难气管插管中的应用效果。方法46例在全麻下行择期手术的患者,麻醉诱导后以Macintosh标准弯喉镜行气管内插管,所有患者喉镜下显露的视野根据Cormack和Lehane分级均在3级以上,经2名熟练的麻醉医师试插管2、3次仍失败,重新面罩给氧1、2min,再以McCoy喉镜进行气管内插管。结果改用McCoy喉镜,声门显露明显改善,其中1级8例,2级29例,3级8例,4级1例,声门显露提高1级31例,提高2级8例,气管插管1次成功39例,2次成功4例,失败3例。结论McCoy喉镜用于困难气管插管效果确切,尤其对那些高喉头、上切牙前凸、舌肥大、甲颏距离短、颈部活动受限、颈椎损伤、下颌骨退行性病变或发育不良等病人有效。
[Objective]To observe the efficiency of McCoy laryngoscope in difficult endotracheal intubation. 46 patients undergoing elective surgeries, after general anesthesia induction, were intubated with standard Macintosh laryngoscope, the views of the larynx were grade 3 or 4 according to Cormack and Lehane classification, and the endotracheal tube cannot be inserted into the trachea after 2～3 attempts by two skilled anesthesiologists. Then the patients were intubated with McCoy laryngoscope after 1～2 minutes mask ventilation. The view of the larynx obtained with McCoy laryngoscope was significantly improved, 8 patients are in grade 1, 29 patients are in grade 2, 8 patients are in grade 3, and 1 patient is in grade 4. The McCoy laryngoscope improved the view by one grade in 31 patients and by two grades in 8 patients. 39 patients were intubated successfully at the first attempt, and 4 patients were intubated successfully after two attempts, only 3 patients′s endotracheal intubation was failed. [Conclusions] McCoy laryngoscope is effective in difficult endotracheal intubation, especially when the patient is in situations like anterior displacement of the larynx, protuberant upper incisors, disproportional large tongue, narrow thyromental distance, restricted neck movement, traumatic cervical spinal, recessive or hypoplastic mandible.
出处
《中国内镜杂志》
CSCD
北大核心
2005年第4期344-345,347,共3页
China Journal of Endoscopy
关键词
MCCOY喉镜
气管插管
困难
McCoy laryngoscope
endotracheal intubation
difficult
