摘要
目的比较KT视频喉镜与Sirius光纤喉镜引导脑瘫患儿气管插管术的效果。方法选择四川省八一康复中心2014年3～12月拟在全身麻醉下行手术治疗的脑性瘫痪患儿150例，ASA分级Ⅰ～Ⅱ级。根据Mallampati气道不同分级将其分为两组，其中Ⅰ-Ⅱ级气道组有。116例，按随机数字表法分为两组：KT视频喉镜组（K1组）和Sirius光纤喉镜组（S1组），每组各58例；Ⅲ～Ⅳ级气道组有34例，按照同样的方法将其随机分为两组：KT视频喉镜组（K2组）和Sirius光纤喉镜组（S2组），每组各17例。麻醉诱导后，K1组和K2组采用KT无线视频喉镜引导下气管内插管，S1组和S2组采用Sirius光纤喉镜引导下气管内插管。记录四组患者麻醉前（T0）、插管前（T1）、插管后1min（T2）、插管后3min（T3）、插管后5min（T4）各时间点的收缩压（SBP）、舒张压（DBP）、心率、脉搏血氧饱和度的变化。采用Cormark—Lehane分级评价声门显露程度。记录四组气管插管成功时的张口度、气管插管时间、首次气管插管成功率以及插管时口唇、齿龈、咽喉部软组织损伤和出血等并发症的发生情况。记录术毕拔除气管导管后声音嘶哑的发生情况。结果与T0比较，四组在T1时SBP及DBP下降（P〈0．05）。K1组与S1组声门显露程度比较差异无统计学意义（Z=1．420,P〉0．05）；与S2组比较，K2组声门显露更完善（Z=5．248，P〈0．01）。与S1比较，K1组气管插管时所需张口度降低（t=16．111，P〈0．01）；与S2比较，K2组气管插管时所需张口度降低（t=15．943，P〈0．01），气管插管时间缩短（t=18．919，P〈0．01），首次气管插管成功率增加（χ^2=43．152，P〈0．01），插管失败率降低（χ^2=12．766，P〈0．01）。与S2组比较，K2组气管插管过程中口唇、齿龈出血、咽喉部软组织损伤发生率及声音嘶哑发生率降低（χ^2=34．634、19．780、68�
Objective To compare KT video laryngoscope and Sirius fiber laryngoscope guided tracheal intubation in chil, dren with cerebral palsy. Methods 150 ASA physical status Ⅰ or Ⅱ children with cerebral palsy from March to December 2014 in Sichuan 81 Rehabilitation Center for elective surgery under general anesthesia, were randomly＇ divided into two groups according to the classification of Mallampati in airway, of which Ⅰ - Ⅱ airway group had 116 cases, were randomly divided into two groups using a random number table： KT video laryngoscope group （group K1） and Sirius fiber laryngoscope group （group St）, with 58 cases in each group; Ⅲ-Ⅳ airway group had 34 cases, were randomly divided into two groups according to the same methods： KT video laryngoscope group （group K2） and Sirius fiber laryngoscope group （group S2）, with 17 cases in each group. After induction of anesthesia, tracheal intubation was carried out by KT video laryngoscope （group K1 and K2） or by Sirius fiber laryngoscope （group St and S2）. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and pulse oxygen saturation （SPOz） in the four groups were recorded before anesthesia （T0）, before intubation （T1）, lmin after intubation （T2）, 3min after intubation （T3） and 5 min after intubation （T4）. The glottis exposure degree was assessed by Cormark-Lehane classification. The distance between upper and lower incisors when intubation was successful, the intubation time, the rate of successful intubation in the first time and the complication such as the damage of lips, teeth, gums, soft tissues of throat and hoarseness after extubation in the four groups were also recorded.Results Compared with group To, the SBP and DBP at T1 were decreased in the four groups （P 〈 0.05）. There was no statistical significance of glottis exposure degree in group K1 and S1 （Z=1.420, P 〉 0.05）; compared with group S2, the glottis exposure was perfect in group K2 �
出处
《中国医药导报》
CAS
2015年第25期78-81,共4页
China Medical Herald
基金
四川省卫计委基金课题(编号130250)
