面部轮廓改形手术中可视喉镜的应用观察

Application of visible laryngoscope in facial contour reshaping

目的 比较可视喉镜和直接喉镜在面部轮廓改形术中气管内插管的成功率、口腔损伤程度及对血流动力学的影响,评价可视喉镜在面部轮廓改形术麻醉中的应用效果.方法 将100例拟施行经口气管插管全身麻醉的患者随机分为可视喉镜组（S组）和喉镜组（M组）.根据综合气道评估分为Ⅰ～Ⅳ级,记录麻醉诱导后（T0）、置入喉镜时（T1）、气管插管后即刻（T2）及气管插管后3min（T3）的平均动脉压、心率、肾上腺素、去甲肾上腺素变化,及插管成功率、插管时间、口腔损伤、插管后并发症的发生情况.结果 T2、T3,M组患者的平均动脉压、心率、肾上腺素和去甲肾上腺素指标较S组明显升高,差异具有统计学意义（P ＜0.05）.M组的口腔损伤和并发症发生率明显高于S组（P ＜0.05）.结论 可视喉镜用于面部轮廓改形手术,插管成功率高、口腔损伤少、对血流动力学影响轻,是一种安全、有效的气管插管器具.

Objective To evaluate the applied results of visible laryngoscope in anesthesia of facial contour reshaping by comparing the success rate of endotracheal intubation, the oral injuries and the hemodynamic changes in facial contour reshaping between the visible laryngoscope and the direct laryngoscope. Methods According to the ASA physical status, 100 patients in Class I-II were randomly divided scheduled into direct laryngoscope （Group S） and visible laryngoscope groups （Group M）. All patients were classified into Class I-V[ according to Mallampati test. The changes of mean arterial pressure; heart rate; adrenaline; noradrenaline were observed at four periods, the time after anesthesia induction （To ）, the time of laryngoscope insertion （T1 ）, the time of instantly intubation （T2 ）, the time at 3 minutes after intubation （T3 ）. The successful rate of intubation, the time of intubation, the oral injuries and the incidence of complications after intubation in two groups were also observed. Results The changes of hemo- dynamic parameters were significant in Group M than that in Group S （ P 〈 0.05）. The oral injuries and the inci- dence of complications were also higher in Group M than those in Group S （ P 〈 0. 05）. Conclusion Compared with the direct laryngoscope in facial contour reshaping,the visible laryngoscope is a safe and effective appliance of tracheal cannula with high successful rate and less oral injuries and hemodynamic changes.