摘要
目的观察Airtraq喉镜用于颈椎手术合并困难气道患者气管插管的效果。方法选择2014年7月-2015年7月于我院择期行颈椎手术的患者80例,随机将其分为A组（Airtraq喉镜）和B组（普通喉镜）,每组40例。静脉麻醉诱导后,两组分别在Airtraq喉镜、普通喉镜引导下经口行气管插管。记录两组患者麻醉诱导前、气管插管即刻和插管后1、2、3 min的平均动脉压（MAP）、心率（HR）及（BIS）值,以及两组喉镜下声门显露情况、插管时间、一次插管成功率和插管总成功率等。结果喉镜下声门显露A组患者均为Ⅰ级,B组患者有14例为Ⅰ级,12例为Ⅱ级,9例为Ⅲ级,5例为Ⅳ级。A组插管时间（10.5±6.2）s,明显短于B组的（75.3±4.1）s（P〈0.05）。A组插管即刻MAP、HR及BIS值均显著低于B组（P〈0.05）;插管后2、3 min MAP和HR均显著低于B组（P〈0.05）,BIS值差异无统计学意义（P〉0.05）。A组所有病例均未行喉部外压动作,B组行喉部外压动作8例,差异有统计学意义（P〈0.05）。A组总成功40例,均一次插管成功;B组总成功36例,其中一次插管成功34例,三次插管成功2例,4例因3次插管后仍未能显露声门,改用纤支镜完成插管,A组一次插管成功率和插管总成功率均明显高于B组（P〈0.05）。结论 Airtraq喉镜用于颈椎活动受限患者气管插管,视野清晰、暴露好,插管迅速,对患者血流动力学影响小,且成功率高、损伤小。
Objective To observe the effect of Airtraq laryngoscope on trachea cannula in patients with cervical vertebrasurgery combining withdifficult airway. Methods From July 2014 to July 2015,80 patients undergone cervical vertebra surgery in our hospital were selected and evenly divided into group A（Airtraq laryngoscope） and group B（common laryngoscope） in random.After intravenous anesthetic induction,tracheal intubation via mouth was implemented under the guidance of Airtraq laryngoscope and common laryngoscope respectively.The values of mean arterial pressure（MAP）,heart rate（HR）,and bispectralindex（BIS） before induction of anesthesia,during instant intubation,and 1,2,3 min after intubation in both groups were recorded as well as glottis exposure under laryngoscope,intubation time,one-time success rate of intubation and total success rate of intubation. Results In the two groups,glottis exposure in group A was in Ⅰ classification,while in group B,the number of classifications in Ⅰ, Ⅱ, Ⅲ and Ⅳwas 14,12,9 and 5 cases in turn.The intubation time in group A was（10.5±6.2） s,much shorter than that in group B of（75.3±4.1） s（P〈0.05）.The values of MAP,HR,and BIS in instant intubation in group A were all greatly lower than those in group B（P〈0.05）.Values of MAP and HR 2,3 min after intubation in group A were obviously lower than those in group B（P〈0.05）,but on significant difference in BIS value（P〉0.05）.In group A,no case was performed with laryngeal external pressure,while in group B,8 patients needed,which displayed a statistical difference.In group A,40 cases of tracheal intubations were all successful only in once.In group B,the number of total success was 36 cases,and one-time success of intubation was 34 cases,2 cases were successful after 3 times of intubation,the rest 4 cases due to no exposure of glottis after 3 times of intubation were switched to bronchofiberscope.The success rate of one-time intubation and total successful rate of intubation in group A
出处
《中国当代医药》
2016年第5期104-106,共3页
China Modern Medicine
关键词
AIRTRAQ喉镜
颈椎手术
困难气道
颈椎活动受限
Airtraq laryngoscope
Cervical vertebra surgery
Difficult airway
Limited move of cervical vertebra
