视可尼纤维喉镜在困难气道中的临床应用

Clinical Observation on the Application of Shikani Laryngo- scope in Difficult Airway

目的观察视可尼喉镜在困难气道中的临床应用,对基层医院选择处理困难气道工具起到借鉴作用.方法 50例困难气道患者随机分成2组:视可尼喉镜组(S),直接喉镜组(M)常规诱导后,由同一名麻醉医师分别用不同插管工具进行气管插管,比较两组插管工具的插管时间和一次性插管成功率,观察两组插管工具在插管过程中对患者血流动力学的影响,记录患者入室安静后(T0)、插管时气管导管进入气管(T1)、插管后2min(T2)、插管后5 min(T3)的HR、SBP、DBP、SpO2,记录气管插管的并反症(牙齿口腔黏膜出血、咽喉痛、声音嘶哑).结果在插管过程中,患者血流动力学变化的比较,同组T1、T2、T3较本组T0差异有统计学意义(P<0.05),两组T2、T3的比较,差异有统计学意义(P<0.05),S组对患者血流动力学的影响较M组小,两组SpO2与T0的比较差异无统计学意义(P>0.05),两组患者插管次数和插管时间比较,S组较M组一次性插管成功率高用时少,差异有统计学意义(P<0.05),两组插管并发症比较差异无统计学意义(P>0.05),可能与样本例数小有关.结论视可尼喉镜较普通喉镜在处理困难气道中具有不可比拟的优势而且方便适用,值得基层医院推广.

Objective To observe clinical application of the apparent Shikani laryngoscope in difficult airway, so as to provide reference for basic-level hospitals to deal with difficult airway. Methods 50 patients with difficult airway were randomly divided into 2 groups： Shikani laryngoscope group （S） that direct laryngoscope group （M） After conventional induction, patients in two groups were given endotracheal intubation with different intubation tools by the same anesthesiologist, then the intubation time and the one-time success rate of intubation were compared between two groups. The hemodynamics of patients, were observed in two groups, the HR, SBP, DBP and SPO2 at before （T0）, during （T1）, 2 min after （T2） and 5 min after intubation （T3） were recorded. The complications including gingival and oral mucosa bleeding, sore throat, hoarseness were also recorded in two groups. Results During the process of intubation, the hemodynamic changes of patients had statistically significant difference between TO and T1, T2,T3 subgroups （P 〈 0.05）, T2 and T3 subgroups （P 〈 0.05） . The intubation had less influence on hemodynamics of patients in group S than M group, but the SPO2 and T0 had no significant difference between two groups （P 〉 0.05） .Comared with M group, the one-time success rate of intubation was higher, and the intubation time was shorter in S group and there were significant differences （P 〈 0.05） . There was no significant difference in the intubation complications between the two groups （P 〉 0.05） , and this may be associated with small sample cases. Conclusion Compared with ordinary laryngoscope, Shikani laryngoscope has incomparable advantages in handling difficult airway and is convenient to apply , so it is worth popularizing in basic-level hospitals.