Tosight视频喉镜用于患儿气管插管的临床研究

The clinical observation of tracheal intubation with Tosight video laryngoscope in children

目的探讨Tosight视频喉镜用于患儿气管插管的临床效果。方法 70例6～15岁ASAⅠ或Ⅱ级患儿,按气管导管的弯曲角度随机均分为:A组(弯曲为60°)和B组(弯曲为80°)。快速诱导后采用Tosight视频喉镜实施经口气管插管操作,观察记录Tosight视频喉镜喉部显露分级、声门暴露时间、气管插管操作时间、插管次数和并发症的发生情况;记录诱导前(基础值)、诱导后、插管后即刻及插管后1、3、5min的SBP、DBP和HR变化。结果所有患儿均成功完成气管插管操作,其中A组3例患儿改变导管的弯曲角度至80°后插管成功,插管总时间A组明显长于B组(P<0.05)。与基础值比较,插管后即刻、插管后1、3、5min两组SBP明显降低;插管后1min两组HR明显增快(P<0.05)。与诱导后比较,插管后即刻,插管后1、3、5min两组HR明显增快(P<0.05)。两组组间比较插管期间SBP、DBP和HR差异无统计学意义,均无严重并发症。结论 Tosight国产视频喉镜用于6岁以上患儿气管插管,具有操作简单方便、影像清晰、声门暴露好、插管成功率高等优点。其中管芯弯曲80°比60°的插管一次成功率高,插管时间明显缩短。

Objective To introduce the clinical experience of tracheal intubation with Tosight video laryngoscope in children. Methods Seventy patients of 6 to 15 years old, ASA Ⅰ or Ⅱ , were scheduled to receive Tosight video laryngoscope oral intubation with rapid sequence induction. According to the endotracheal tube bending angle, the patients were randomly divided into 2 groups： Group A （rigid stylet angle 60, n=35） and group B（rigid styler angle 80, n=35）. The Cormack- Lehane grade, glottic exposure time, time of intubation and complications were observed and recorded. To record the SBP,DBP and HR before induction （base value）,after induction, the moment of intubation and 1,3,5 min after intubation. Results All patients were successfully intubated with Tosight video laryngoscopy. In group A, 3 patients were intubated with the second try after modifying the styler to 80. The mean duration of intubation in group A was longer than that in group B （P〈0.05）. The SBP at the moment of intubation and 1,3,5 rain after intubation in both the two groups were lower than the base value,and the HR at 1 rain after intubation were faster （P〈0.05）. The HR at the moment of intubation and 1,3,5 min after intubation were faster than induction in the two groups（P〈0.05）. There was no difference in hemodynamics in the two groups. Neither group had serious complications. Conclusion Tosight laryngoscopy is a new domestic video laryngoscope for children patients more than 6 years old. It has the advantage of being easy to handle, clear image, good glottic visualization and high successful intubation rate. The stylet angle 80 has more advantages than 60 in intubation rate and intubation time.