Glidescope视频喉镜在头颈外科手术老年患者气管插管中的应用

Application of Glidescope video laryngoscope in geriatric patients who accepted head-neck surgery during tracheal intubation

目的评价Glidescope视频喉镜用于头颈外科手术老年患者气管插管的临床效果。方法择期行头颈外科手术的老年患者40例,随机分为Glidescope视频喉镜组(G组20例)和直接喉镜组(L组20例)。全部患者均于麻醉前进行改良Mallampati分级评估,分析比较两组患者声门暴露情况(Cormark-Lehane分级)、插管时间,记录麻醉诱导前(T0)、诱导后(T1)、插管后不同时点(T2～T5)的血流动力学变化。结果与L组比较,G组患者获得较好的声门暴露,且插管时间缩短(P<0.05)。两组患者T1时点MAP、HR较T0时点有所降低(P<0.05),T2～T5不同时点MAP、HR较T0时点有不同程度增加(P<0.05),两组比较差异无统计学意义(P>0.05)。结论 Glidescope视频喉镜可以为头颈外科手术老年患者创造更好的插管条件,提高插管成功率。

Objective To evaluate the effects of Glidescope video laryngoscope in geriatric patients who accepted head - neck surgery during tracheal intubation. Methods Forty geriatric patients who ac- cepted head -neck surgery were randomly divided into two groups （n = 20, each） ： Group G （Glidescope video laryngoscope） ; Group L （ direct laryngoscope）. Modified Mallampati test was used for airway predic- tion before anesthesia. The following data were recorded and analyzed： glottic exposure （ Cormark - Le- hane）, tracheal intubation, hemodynamic parameters at the point of before induction （T0 ）, after induction （ T2 ）, the different time points of intubation （ T2 - T5 ）. Results Compared with Group L, Group G a- chieved better glottic exposure and shorter intubation time. Compared with the baseline at To, MAP and HR were markedly decreased at T1while MAP and HR were obviously increased at T2 - T5in two groups. There was no significant difference in MAP and HR between Group G and Group L Conclusions Glidescope video laryngoscope can yield better glottic exposure and higher success rate in geriatric patients who accepted head - neck surgery during tracheal intubation.