电子支气管镜与纤维支气管镜插管技术在颈椎手术患者中的应用比较

Comparison of bronchovideoscope and fiberoptic bronchoscope guided endotracheal intubation in patients undergoing cervical surgery

目的观察比较电子支气管镜与纤维支气管镜引导经口气管插管在颈椎手术患者中的应用效果。方法将32例拟经口气管插管全麻下行颈椎手术的ASAⅠ-Ⅱ级患者随机分为电子支气管镜组(A组)和纤维支气管镜组(B组),记录两组基础值(T0)、插管前即刻(T1)、插管后即刻(T2)、插管后5 min(T3)的平均动脉压(MBP)、心率(HR),插管时间,一次插管成功率及插管相关并发症。结果与T0期比较,两组患者T1期MBP和HR降低,随后在T2期明显升高,到T3期MBP再次降低,差异有统计学意义(P<0.05)。与A组相比,B组气管插管时间延长,差异有统计学意义(P<0.01),其中1例一次插管失败。两组插管相关并发症发生率差异无统计意义(P>0.05)。结论与纤支镜比较,电子镜能明显缩短颈椎手术患者气管插管的时间和提高一次插管成功率。

Objective To compare the effects of bronchovideoscope and fiberoptic bronchoscope guided endotracheal intubation in patients undergoing cervical surgery. Methods Thirty-two patients undergoing cervical operations under general anesthesia were randomly divided into bronchovideoscope group （Group A） and fiberoptic bronchoseope group （Group B）. Intubation time, intubation success rate, intubation-related complications, mean blood pressure （MBP） and heart rate（HR） before anesthesia induction （T0）, immediately before （T1） and after （T2）, 5 min （T3） after tracheal intubation were recorded. Results MBP and HR of both groups decreased at T1 , increased at T2 and decreased again at T3 （P〈0.05）. Compared with group A , the intubation time of group B was longer （P〈0.01） with one failed on the first attempt. There was no significant difference in the intubation related complication between two groups. Conclusion Compared with group B, bronchovideoscope technique could shorten the endotracheal intubation time with higher success rate of one-tine intubation in patients undergoing cervical surgery.