摘要
目的评价对垂体瘤肢端肥大并有插管困难的患者应用Bonfils纤维喉镜行气管插管的方法。方法经全麻气管插管行垂体瘤切除术的患者15例,术前先行气道评估,若M allampati评分≥3级或甲颏距离<6 cm、张口度<3.5 cm,三项有一项者被选入。常规麻醉诱导后用Bonfils纤维喉镜插管,记录诱导前、插管前、插管后的血流动力学变化。按插入口咽腔、看见会厌、进入声门和置入气管导管的难易度评估插管情况并记录插管时间和失败率,同时随访插管后咽痛声嘶等不良反应。结果插管后收缩压和心率均有增加(P<0.05)。所有患者均一次插管成功,平均插管时间为(65.3±10.6)s,有4例(26.7%)患者看见会厌的难易度为一般,2例(13.3%)患者进入声门较困难。除2例患者外所有患者术后无咽痛、声嘶等不良反应。结论Bonfils纤维喉镜对于插管困难的患者是一种简便、易行的插管装置。
Objective To evaluate the clinical intubation of Bonfils intubation fiberscope in difficult airway of acromegaly patients. Methods Fifteen acromegaly patients who have one of the following criteria of preoperative airway assessment, Mallampati score ≥3, thyromental distance ≤6 cm, mouth opening ≤3.5 cm. After routine anesthetic induction the patients were intubated with Bonfils intubation fiberscope. Haemodynamic changes were observed and handling of the Bonfils intubation fiberscope was evaluated in terms of the ease of insertion into oropharynx, visualization of epiglottis, advancement into glottis aperture and slide down the tracheal tube. Intubating time and success rate were also recorded. Postoperatively, Results After intubation systolic pressure and heart sore throat or hoarseness were followed up for all rate increased as compared with pre-intubation （P patients 〈0. 05）All patients were successfully intubated in one attempt. Mean intubating time was 65.3±10. 6 s. The ease of visualization of epiglottis were fair in 4 patients （26.7%） and two patients （ 13.3% ） was difficult in advancement the fiberscope into glottis aperture. All patients but two have no obvious sore throat or hoarseness postoperatively. Conclusion The Bonfils intubation fiberscope appears to be a simple and effective technique for difficult airway patients.
出处
《基础医学与临床》
CSCD
北大核心
2006年第9期1015-1018,共4页
Basic and Clinical Medicine
