传统喉镜与可视可塑型硬光纤喉镜合用于困难插管效果分析

The effect analysis of traditional laryngoscopy and shikani optical stylet (SOS) combined application in difficult intubation

目的探讨传统喉镜与可视可塑型硬光纤喉镜(SOS)合用于困难气管插管的效果。方法在择期全麻手术患者中,选择预计麻醉时存在插管困难者40例,随机分为两组,A组20例采用传统喉镜插管;B组20例采用传统喉镜与SOS合用进行气管插管。选择4个时点,即麻醉诱导后(T0),气管插管即刻(T1),插管后2min(T2),插管后5min(T3),记录患者有创桡动脉血压,即收缩压(SBP)和舒张压(DBP),心率(HR),连续观察心电图(ECG)和血氧饱和度(SpO2)变化,观察有无心律失常、呼吸抑制等插管并发症,并比较插管次数及插管所用时间。结果 A组一次插管成功率为50%,B组一次成功率为95%,且成功插管所需时间明显短于A组(P<0.05)。A组SBP和DBP在插管后均增高,B组在插管后5min恢复正常。在T0、T1时点,A、B组SBP和DBP无统计学差异。A组SBP和DBP在T2、T3高于B组(P<0.05)。A、B组HR在插管后T1、T2均增高(P<0.05);A组在T3时点高于B组(P<0.05)。结论两种喉镜的复合使用,缩短了插管时间,确保插管成功,降低了插管不良反应及困难插管并发症,保障患者生命体征更加平稳。

Objective To study the effect of traditional laryngoscopy and shikani optical stylet （SOS） combined application in difficult intubation.Methods Forty patients predicted difficult intubation were chosed in the elective surgery for general anesthesia and randomly divided into two groups,patients in group A of 20 cases were intubated with traditional laryngoscope,patients in group B of 20 cases were intubated with both traditional laryngoscope and SOS.The changes of radial artery blood pressure （SBP and DBP）,HR were recorded in the four times of after narcotic induction （T0）,when intubation （T1）,after intubation （T2）,after intubation for 5 min （T3）.And the changes of ECG and SpO2 were observed continuously.Complications of intubation such as arrhythmia,respiratory inhibition were watched.The intubation frequency and time were compared.Results The intubate successful rate for one time were 40% in group A,and 95% in group B.The intubation time of group B was shorter than group A obviously （P 0.05）.Both SBP and DBP increased after intubation in group A,and they backed to normal after intubation for 5 minutes in group B.SBP and DBP had no significant differences between two groups at T0 and T1.SBP and DBP in group A at T2,T3 were significantly higher than those in group B （P0.05）.HR increased in two groups at T1 and T2 （P 0.05）.HR in group A at T3 were higher than those in group B （P0.05）.Conclusion The combined application of traditional laryngoscopy and SOS shortens the intubation time,decreases complications of difficult intubation and ensures vital signs of patients more smoothly.