困难气管内插管的预测和处理

Prediction and disposal of difficult endotracheal intubation

目的 探讨对困难气管内插管的预测及处理方法。方法 随机选取各类需行气管内插管麻醉下择期手术患者 5 0例 ,术前测量IG、Slux、TM、HENE、HFNF、气道分类及声门分级等各项指标 ,并分析它们与气管插管难度之间的关系。结果 5 0例患者中 ,气道分类Ⅳ类者 7例 ,声门分级Ⅲ级者 17例 ,Ⅳ级者 1例。 17例声门Ⅲ级者以EtCO2 引导下口腔盲插法插管成功 ,1例声门Ⅳ级者以气囊充气鼻腔盲探气管内插管法插管成功。结论 术前评价气管插管难易程度应综合考察各项测量指标 。

Obecetive To investigate prediction and disposal of difficult endotracheal intubation.Method 50 patients who needed to be operated with endotracheal intubation anesthesia were chosen randomly.Different indexes including IG,Slux,TM,HENE,HFNF,classification of air passages and grading of glottides were measured preoperatively,and the relationships between these indexes and the difficulty of endotracheal intubation were analyzed.Result The classification of air passages of 7 cases was grade Ⅳ among 50 cases,and the grade of glottides of 17 cases was grade Ⅲ and one case was grade Ⅳ.17 cases with grade Ⅲ of glottides were anesthetized successfully with endotracheal intubation through cavum oris under leading of EtCO 2.One case with grade Ⅳ of glottides was anesthetized successfully with blind endortacheal intubation through nasal cavity.Conclusion These indexes above should be inspected synthetically to evaluate the difficulty of endotracheal intubation preoperatively.The grade of glottides was the most reliable index among these indexes.