Discoscope内窥镜与GlideScope可视喉镜用于声门显露困难患者气管插管效果的比较

Efficacy of Discoscope endoscope versus GlideScope video laryngoscope for difficult glottis exposure

目的比较Discoscope内窥镜与GlideScope可视喉镜用于声门显露困难患者气管插管的效果。方法择期行经口气管插管的全麻患者40例，Macintosh喉镜显露Corrnach—Lehane分级Ⅲ或Ⅳ级，性别不限，年龄24—78岁，采用随机数字表法，将患者随机分为2组（n=20）：G｜ideScope可视喉镜组（G组）和Discoscope内窥镜组（D组）。记录声门显露情况、声门显露时间、气管插管情况、声门显露后至气管导管置人时间和气管插管时间。术后随访患者，记录咽喉出血和咽喉疼痛的发生情况。结果与G组比较，D组声门显露时间延长，环状软骨按压率降低，声门显露至气管导管置人时间缩短，1次气管插管成功率升高（P〈0．05），1次声门显露成功率、2次声门显露成功率、2次气管插管成功率、气管插管时间、咽喉出血发生率和咽喉疼痛发生率差异无统计学意义（P〉0．05）。结论与GlideScope可视喉镜比较，Discoscope内窥镜用于声门显露困难患者有助于声门的显露，且可提高气管插管的成功机率。

Objective To compare the efficacy scope for difficult glottis exposure. Methods Forty adult of Discoscope endoscope and GlideScope video laryngopatients of both sexes scheduled for elective surgery under general anesthesia whose glottis was not visible at laryngoscopy （grade 111 or IV according to Cormach-Lehane Grading of laryngoscopic view） were randomized into 2 groups （ n = 20 each） ： group GlideScope video laryngoscope （group G） and group Discoscope endoscope （group D）. The glottis exposure time, intubating conditions, time from exposure of glottis to completion of tracheal intubation arid incidence of postoperative sore throat and throat bleeding were recorded and compared between the 2 groups. Results Compared with group G, the glottis exposure time was significantly longer, the rate of backward pressure of cficoid cartilage lower, the time from expo- sure of glottis to completion of tracheal intubation shorter and the success rate of tracheal intubation at first attempt higher （ P 〈 0.05）. There was no significant difference in the success rate of tracheal intubation at second attempt and postoperative incidence of sore throat and throat bleeding between the 2 groups（ P 〉 0.05）. Conclusion DiscoScope endoscope is superior to GlideScope video laryngoscope in the management of difficult intubation in term of glottis exposure and success rate of tracheal intubation at first attempt.