摘要
目的 探讨GlideScope 可视喉镜在双腔支气管（double-lumen endobrochial tube,DLT）插管中的应用价值.方法 选取拟行胸科手术患者80例,ASA分级Ⅰ～Ⅱ级,Mallampati分级Ⅰ～Ⅱ级,随机分成两组：可视喉镜组（G组）和直接喉镜组（D组）,每组40例.G组在GlideScope 可视喉镜加同一厂家特制加长配套管芯下行双腔支气管插管,D组在直接喉镜下以传统方法行双腔支气管插管.两组患者在插管完成后均用纤维支气管镜确认是否到位及调整位置.记录两组患者插管期间生命体征的变化、插管时间、一次插管成功率和术后48 h内并发症的情况.结果 插管前、插管即刻及插管后5 min,两组心率（heart rate,HR）平均水平比较,差异有统计学意义（F=35.01,P＜0.0001）,且G组的HR平均值相对较小;两组平均动脉压（mean artery pressure,MAP）平均水平比较,差异有统计学意义（F=61.02,P＜0.001）;G组与D组插管平均时间分别为（5.7±1.2）min与（8.6±1.4）min,两组插管时间比较有统计学差异（F =98.53,P＜0.001）;G组一次性插管成功率为90.0％,明显高于D组的70.0％,两组比较差异有统计学意义（χ2=5.000,P=0.030）;两组术后48 h内并发症的构成明显不同（Fisher精确概率计算得P＜0.001）.结论 GlideScope 可视喉镜在双腔支气管插管中可以提高插管的成功率,降低插管时的应激反应,减少术后插管相关并发症.
Objective To explore the clinical application of GlideScope video laryngoscope in double-lumen endobronchial tube （DLT） intubation. Methods 80 cases of patients（ ASA Ⅰ- Ⅱ, Mallampati classification Ⅰ -Ⅱ ） scheduled for thoracic sur- gery were randomly divided into two groups, 40 cases each） ： GlideScope video laryngoscope group （group G） and direct laryngoscope group （group D）. In group G, GlideScope video laryngoscope with extended supporting tube core specially made in the same manufacturer was used to guide the double-lumen tube bronchial intubation; in group D, the double-lumen endobronchial tube was in- tubated with conventional direct laryngoscope. After successful intubation, fiberoptic bronchoscope was used to adjust and confirm the position of double-lumen endobronchial tube in both of the two groups. The changes of vital signs during intubation, the intubation time consuming, one-time intubation success rate and postoperative complications within 48 hours were recorded and compared between the two groups. Results Before intubation, immediate intubation and 5 minutes after intubation, the heart rate （HR） average of two groups were compared, the difference was statistically significant （F = 35.01, P 〈0.0001 ）, and the HR average of group G is relatively smaller; the mean arterial pressure （MAP） average of two groups were compared, the difference was statistically significant （F = 61.02, P 〈 0. 001 ） ; the average intubation time of group G and D respectively were（5.7±1.2） rain and （8.6±1.4） rain, the difference between their intu- bation time was statistically significant （ F = 98.53, P 〈 0.001 ） ; one-time success rate of intubation for Group G was 90.0% , signifi- cantly higher than that of group D （70.0%）, and the difference was statistically significant （χ2 = 5. 000,P = 0. 030） ; the composition of postoperative complications of two groups within 48 h were obviously different （ Fisher＇ s exact probability calculation P
出处
《中华灾害救援医学》
2014年第9期504-507,共4页
Chinese Journal of Disaster Medicine
关键词
可视喉镜
直接喉镜
双腔支气管插管
纤维支气管镜
GlideScope video laryngoscope
direct laryngoscope
double-lumen endobronchial tube intubation
fiberoptic bron-choscope
