急诊抢救中光棒引导法与直接喉镜法气管插管效果比较

Effect comparison of tracheal intubation between light-wand direction and direct laryngoscope method in emergency department

目的：比较在急诊抢救过程中采用光棒引导法与直接喉镜法进行气管插管的临床效果,探索该方法在急救领域的适用性。方法：将2010年2~6月来我院急诊科就诊的80例患者随机分为两组,每组各40例,分别采用光棒引导法（光导组）与常规直接喉镜法（常规组）进行气管插管,比较两组的插管时间、一次插管成功率、咽喉部损伤程度及插管后疼痛时间。结果：插管时间[光导组（31.23±9.94）s,常规组（48.15±8.67）s]、疼痛时间[光导组（3.45±1.34）d,常规组（5.33±1.65）d]和咽喉部损伤程度比较,光导组低于常规组,差异均有统计学意义（均P〈0.05）;而一次插管成功率[光导组（97.5%）,常规组（80.0%）]高于常规喉镜组,差异有统计学意义（P〈0.05）。结论：在急救过程中,与常规直接喉镜气管插管相比,光棒引导法具备操作简便易行、插管时间短、一次插管成功率高、对咽喉部损伤小的优点,是一种适宜在急诊科室推广的气管插管技术。

Objective： To compare the effect of tracheal intubation between light-wand direction and direct laryngoscope method in the process of emergency rescue and evaluate the feasibility of using light-wand direction.Methods： From February to June 2010,80 patients in emergency department of our hospital were randomly allocated to receive either light-wand direction tracheal intubation（light-wand group,n=40） or direct laryngoscope tracheal intubation（convention group,n=40）.Time and first success rate of intubation,throat injury level and duration of pain after intubation were compared between the two groups.Results： Time of intubation [light-wand group（31.23±9.94）s,convention group（48.15±8.67）s],duration of pain after intubation [light-wand group（3.45±1.34）d,convention group（5.33±1.65）d] and throat injury level were compared,those in light-wand group were significantly lower than those in laryngoscope group（all P〈0.05）.The success rate of first intubation in light-wand group was higher than that in laryngoscope group [light-wand group（97.5%）,convention group（80.0%）（P〈0.05）.Conclusion： Compared with direct laryngoscope tracheal intubation method,light-wand direction tracheal intubation has an easier operation,less time of intubation,higher first success rate and lower throat injury level.Therefore,it is a desirable intubation technology which is appropriate to perform in emergency department.