Coopdech支气管阻塞器在困难气道患者中的应用

Clinical Observation of Difficult Intubation Guided by Coopdech Bronchial Blocker

目的观察Coopdech支气管阻塞器引导困难气管插管的临床效果。方法术前评估为困难气道的患者30例,随机分为Coopdech支气管阻塞器引导组(C组,n=15)和双腔支气管导管盲探组(S组,n=15)。C组将套有气管导管的Coopdech支气管阻塞器前端弯曲朝上,盲探送入会厌下端,观察刻度进入10 cm时,将气管导管顺Coopdech支气管阻塞器滑入声门。S组将带管芯的双腔支气管导管前端弯曲呈鱼钩形状,由会厌下端盲探送入声门。记录两组患者麻醉诱导和气管插管期间心率、血压和SpO2,同时记录第一、二次插管成功率,以及患者声门水肿、口咽部损伤、咽喉痛和声音嘶哑等并发症情况。结果两组患者各时点血流动力学和SpO2比较差异无统计学意义。C、S两组第一次插管成功率分别为86.7%和40.0%,两组比较差异均有统计学意义(P<0.05),两组第二次插管成功率分别为13.3%和20.0%,两组比较差异无统计学意义(P>0.05)。S组有7例患者拔管时气管导管粘血,而C组只有1例;S组术后咽痛有9例,而C组咽痛只有1例;两组比较差异均有统计学意义(P<0.05)。结论 Coopdech支气管阻塞器引导困难气管插管能明显提高插管成功率。

Objective To observe the clinical efficacy of the Coopdech Bronchial Blocker guiding the difficult intubation.Methods In this study,30 patients who had difficult airway before surgery were randomly allocated to two groups： group C（n=15） received intubation of the Coopdech Bronchial Blocker,and group S（n=15） received blind orotracheal intubation.In group C,the Coopdech Bronchial Blocker was inserted through the endotracheal tube and the marking point 10 cm from the tip reached the edge of the epiglottis,then the tube was slid over the blocker and advanced into the trachea.And double lumen endobronchial tube bent like fish-hook shape,was blind into the glottis in group S.Heart rate,blood pressure and SpO2 were recorded during anesthesia induction and intubation in two groups.Meanwhile,the first and second intubation achievement ratio,complications such as glottic oedema,pharynx oralis injuries,sore throat and hoarseness were also recorded.Results There was no significant difference on hemodynamics and SpO2 at each point between two groups.In group C and S,there was significant difference in the first intubation achievement ratio（86.7% and 40.0%,respectively,P0.05）.But the second intubation achievement ratio was 13.3% and 20.0%,separately,there was no significant difference between them（P0.05）.There were 7 patients occurred tube blood in group S,but only 1 patient in group C,and there were 9 patients had sore throat in group S but only 1 patient in group C,there was significant difference between them（P0.05）.Conclusion Difficult intubation guided by the Coopdech Bronchial Blocker could obviously improve blind orotracheal intubation achievement ratio.