三种逆行性气管插管引导方法临床应用比较

The clinical application comparison of three kind of guide method for the retrograde trachea cannula.

目的比较三种逆行性气管插管引导方法应用于插管困难患者的临床比较。方法选取96例气管插管困难的手术患者为研究对象，根据逆行性气管插管引导方法不同均分为Ⅰ组、Ⅱ组和Ⅲ组，Ⅰ组32例患者给予常规中心静脉穿刺导丝引导；11组32例患者给予导管引导；III组32例患者给予“穿针法”中心静脉穿刺导丝引导，回顾性分析三种逆行性气管插管引导方法的插管时间、一次插管成功率以及插管并发症。结果Ⅰ组患者插管时间为（15．2±2．1）min，Ⅱ组患者插管时间为（9．1±1．1）min，Ⅲ组患者插管时间为（5．2±0．9）min，Ⅰ组患者插管时间最长，Ⅲ组患者插管时间最短，三组分别比较均有统计学意义（P〈0．05）。Ⅲ组插管一次成功率为96．86％，高于Ⅱ组（43．75％）和Ⅰ组（37．5％），比较差异有统计学意义（P〈0．05）；Ⅱ组患者一次插管成功率与Ⅰ组比较无统计学意义（P〉0．05）。Ⅰ组、Ⅱ组和Ⅲ组患者术后咽痛发生率为9．38％，3．13％和3．13％，比较差异无统计学意义（P〉0．05）。结论“穿针法”引导逆行气管插管操作时间短，成功率高，临床效果优于导丝和导管引导法逆行气管插管，值得临床推广。

Objective To compare the clinical application of three kind of guide method for the retrograde trachea cannula in patients with difficult intubation. Methods 96 cases of surgical patients with difficult tracheal intubation were selected as the research object, and according to guide method were divided into the group I , group II and group Ill. 32 patients in the group I given conventional center venipuncture godet guide, 32 patients in the group II catheter guide, and 32 patients in the group III given ＂thread needle method＂ center venipuncture godet guide. The intubation time, the first time silicon success rate and intubation complications of the three groups were retrospectively analyzed. Results The intubation time of the the group I , group II and group m were 15.2 ±2. lmin,9.1 ± 1. lmin and 5.2±0.9min, which of the group I was longest and of the group III was shortest, the differences among three groups were all statistical significance （ P 〈 0.05 ）. The first time silicon success rate of the the group III was 96.86% , which were higher than of the group II （43.75%） and group I （ 37.5% ）, the differences were all statistical significance （χ2III-I = 5.19, χIII-II = 3.86, P 〈 0.05） ; the differences between the group I and group 11 were not statistical significance （ P 〉 0.05 ）. The occurring rate of postoperative sore throat of the the group I , group II and group ]II were 9.38% , 3.13% and 3.13%, the differences were not statistical significance （P 〉 0.05）. Conclusion The operation time of the ＂ thread needle method ＂ center venipuneture gudet guide for retrograde trachea cannula is shorter, the success rate is higher, and the clinical effect is better than the godet guide and catheter guide method retrograde tracheal cannula, which is worth of clinical fpromotion.