Discopo气管插管内镜在喉部新生物患者全身麻醉插管中的应用

Discopo optical laryngoscope for tracheal intubation in patients with neoplasm of larynx

目的评估一种新型的可视管芯(Discopo气管插管内镜)在喉部新生物患者全身麻醉气管插管中的作用。方法选择2011年1—12月间因喉部新生物择期行支撑喉镜手术的患者200例,随机分成普通喉镜组和内镜组,每组100例。全身麻醉诱导后两组患者分别应用Macintosh喉镜或Discopo气管插管内镜插入气管导管。观察并记录两种气管插管方法所需时间和插管次数,插管前和插管时的收缩压(SBP)、舒张压(DBP)、心率(HR),以及与气管插管相关的损伤发生率。结果内镜组的气管插管时间显著短于普通喉镜组(P<0.05),一次气管插管成功率显著高于普通喉镜组(P<0.05)。两组间气管插管前的SBP、DBP和HR的差异均无统计学意义(P值均>0.05)。普通喉镜组在气管插管时的SBP、DBP和HR均显著高于内镜组(P值均<0.05),普通喉镜组在气管插管时的SBP、DBP和HR均显著高于气管插管前(P值均<0.05),而内镜组在气管插管时的SBP、DBP和HR均与气管插管前的差异无统计学意义(P值均>0.05)。内镜组的气管插管相关并发症新生物出血和黏膜损伤的发生率显著低于普通喉镜组(P值均<0.05)。结论与Macintosh喉镜相比,使用Discopo气管插管内镜进行气管插管的耗时较少,一次插管成功率较高,气管插管过程中血流动力学更稳定,气管插管相关损伤较少。

Objective To investigate the application of a new visual stylet （Discopo optical laryngoscope） for tracheal intubation in patients with neoplasm of larynx under general anesthesia. Methods From January to December 2011, 200 larynx neoplasm patients scheduled for suspension laryngoscopic surgery were randomly divided into Macintosh direct laryngoscope group and Discopo optical laryngoscope group （n = 100）. After intravenous induction, the patients were orally intubated with Macintosh direct laryngoscope or Discopo optical laryngoscope in each group. Parameters, including intubation time, success rate of first intubation attempt, systolic and diastolic blood pressure （SBP and DBP） and heart rate （HR） before and during intubation, complications were recorded. Results Compared with Macintosh group, the intubation time was significantly shortened and the success rate of the first intubation attempt was significantly increased in Discopo group （P〈 0.05）. There were no statistical differences in SBP, DBP and HR between two groups before intubation （P〉 0.05）. SBP, DBP and HR during tracheal intubation in Macintosh group were significantly higher than those before intubation in Macintosh group and those during intubation in Discopo group （P〈0.05）. However, there were no statistical differences in SBP, DBP and HR between before and during intubation in Discopo group （P〉0.05）. The incidence of complications during intubation was significantly lower in Discopo group than that in Macintosh group （P〈0.05）. Conclusion Compared with Macintosh laryngoscope, Discopo optical laryngoscope needs less time consumption and has complications, higher success rate for the first intubation attempt, and more stable hemodynamic responses in tracheal intubation.