摘要
目的:探索一种简单、方便、可靠的潜在困难气管插管处理方法。方法:选择ASAⅠ～Ⅱ级,Mallampntis实验评估Ⅲ～Ⅳ级,拟在全麻下行择期手术的潜在困难气管插管患者,共120例。将患者随机分为观察组与对照组,每组各60例。观察组采取左侧磨牙入路,对照组采取正中入路。2组均以瑞芬太尼、丙泊酚、琥珀胆碱快速静脉诱导,随后观察组用喉镜经左侧磨牙入路显露声门气管插管,对照组采用正中入路显露声门气管插管。记录2种路径置入时声门显露程度、改用纤维支气管插管病例数、插管难易程度。结果:声门显露程度观察组好于对照组(P<0.05),IDS评分观察组较对照组低(P<0.05),改用纤维支气管插管比例观察组少于对照组(P<0.05)。结论:对潜在困难气管插管患者使用静脉快速诱导麻醉后,喉镜经左侧磨牙入路有利于声门的暴露,能提供较好的气管插管条件,提高插管成功率,简单、方便、可靠,可作为潜在困难气管插管的一种新选择。
Objective：To explore a simple, convenient, reliable intubation approach for potentially difficult. Methods：According to ASA Ⅰ～Ⅱ level, Mallampntis experimental evaluation grade Ⅲ～Ⅳ, 120 cases of the potentially difficult tracheal intubation in elective surgery under general anesthesia were randomly divided into the left molar group （study group） and midline approach group （control group of 60 cases）. The two groups had remifentanil, propofol, succinylcholine rapid intravenous induction, and in the observation group were exposed the glottis, tracheal intubation with a laryngoscope in the left side of molar approach; in the control group by the midline approach revealed the glottis, to tracheal intubation. Recorded the two paths, the extent and number of fiberoptic bronchoscopy intubation. The difficult intubation score （IDS） were assessed. Results：The extent of glottis revealed in the observation group were better than in the control group （P 〈 0.05）. In the observation group IDS score was low （P 〈 0.05）. In fiber bronchial intubation ： there were（1.67% ） in the observed group, （8.33%） in the control group （P 〈 0.05）. Conclusion： When there are the potential difficulty of endotraeheal intubation after rapid intravenous induction of anesthesia, the laryngoscope in the left molar into the road to exposure glottis can provide better intubating conditions, improve the intubation success rate, be simple, convenient, reliable.
出处
《现代临床医学》
2012年第6期424-426,共3页
Journal of Modern Clinical Medicine
关键词
喉镜
磨牙
正中
气管插管
路径
laryngoscope
molar
midline approach
tracheal intubation
path
