Shikani喉镜不同入路和直接喉镜经口气管插管对血流动力学影响的比较研究

Comparison of the Effects of Different Approaches with Shikani Laryngoscope and Orotracheal Intubation with Direct Laryngoscope on the Hemodynamics

目的对比观察Shikani喉镜正中入路、左侧磨牙入路和Macintosh喉镜经口气管插管对血流动力学的影响.方法选择60例ASAⅠ～Ⅱ级、年龄18～65岁,拟在经口气管插管全身麻醉下行择期手术的患者,随机分为Shikani喉镜正中入路组(A组,20例)、Shikani喉镜左侧磨牙入路(B组,20例)和Macintosh直接喉镜组(C组,20例).麻醉诱导后分别采用Shikani喉镜或Macintosh喉镜实施经口气管插管操作,观察三组患者麻醉诱导前、后,气管插管时和气管插管完成后1min、5min内的血压、心率(HR)的变化,并记录气管插管完成所需时间,有无并发症.结果Macintosh直接喉镜气管插管和Shikani喉镜正中入路、左侧磨牙入路经口气管插管相比较,可出现相对较轻的血流动力学反应,而Shikani喉镜正中入路、左侧磨牙入路两者相比较血流动力学无明显差异.三者完成插管的时间和气管咽喉部粘膜损伤亦无明显差异.结论Shikani可视可塑硬光纤喉镜及其插管方法是一种迅速、准确、有效解决困难气管插管的先进工具和全新的有效手段和方法.

Objective To compare the effects of the Shikani laryngoscope through the access of middle,through the access of left molar approach and the orotracheal intubation with Macintosh laryngoscope on the hemodynamics.Methods Sixty patients were selected（with ASA Ⅰ～Ⅱ grade,aged from 18 to 65 years）.Those patients undergoing the general anesthesia and elective surgery were randomly divided into Shikani laryngoscope midline approach group（A group,20 cases）,Shikani laryngoscope left molar approach gruop（B group,20 cases） and the Macintosh direct laryngoscope group（C group,20 cases）.After induction,we used the Shikani laryngoscope to insert the tubes into trachea through the access of middle and the access of left molar approach in group A and group B respectively.The Macintosh laryngoscope was used to complete intubation in group C.We observed the changes of heart rate（HR）,arterial blood pressure after endotracheal intubation in 1 min,5 min in three groups.And we recorded the time required to complete endotracheal intubation and observed t in three groups.Results There was a minor hemodynamic change in group C,comparesd with group A and group C,and there was no difference in hemodynamics between group A and group B.The time of complete intubation and the throat mucosa injury had no significant difference among the three groups.Conclusions Shikani visual plastic fiber optic laryngoscopy is a fast,accurate and effective solution to difficult tracheal intubation.It is an advanced tools and a neweffective method.