光导管芯用于气管插管的临床研究

Clinical Observations on Lighted Stylet Used for Endotracheal Intubation

目的 :对比研究光导管芯和普通喉镜气管插管的成功率 ,两种方法对循环系统和口腔内损伤的影响 ,评价光导管芯气管插管的临床效果。方法 :2 4 0例ASAI～II级拟行气管插管病人随机分为光导管芯气管插管组和普通喉镜气管插管组 ,分别按Mallampati试验分为I～IV级。每例病人插管次数限定 3次 ,超过 3次记为失败 ;同时记录第一次插管前 1min、插管中、插管后 1min 3个时相两组患者SP、DP、MAP、HR及SpO2 变化。结果 :光导管芯插管成功率为 92 .5 % ,其中 3次插管成功率分别为 75 .8%、11.7%、5 .0 % ,失败率为 7.5 % ;普通喉镜插管成功率为96.7% ,其中 3次插管成功率分别 89.2 %、4 .2 %、3 .3 % ,失败率为 3 .3 %。两组比较差异无显著性 (P >0 .0 5 ) ;光导管芯插管时SP、DP、MAP、HR在插管前 1min、插管中、插管后 1min差民无显著性 (P >0 .0 5 ) ,但普通喉镜插管时有显著性变化 (P <0 .0 1)。MallampatiI、II级两组患者无明显的口腔内损伤 ,而III、IV级患者光导管芯插管比普通喉镜插管口腔内损伤及患者不适感明显较轻。结论 :光导管芯气管插管对循环影响小 ,它是一种损伤轻、安全。

Objectives:To evaluate the clinical usefulness of Lighted Styled in endotracheal intubation by comparing it conventional laryngoscopy and observing its success rate of intubation and influence on circulation and injuries to oral cavity. Methods: 240 patients (ASA I～II) were randomized to two groups: those receiving Lighted Stylet (Group LS, n=120) and those receiving conventional laryngoscopy (Group CL, n=120). All patients were classified into Class I～IV ac cording to Mallampati test. The frequency of each intubation was limited to three times, or it was deemed failure. Changes of hemodynamic parameters (SP, DP, MAP, HR, SpO 2) were observed at three periods, one minute before intubation and during intubation, one minute after intubation. Results: Successful intubation occurred in 92.5% of the patients in Group LS and in 96.7% of the patients in Group CL. The success rate of three times is 75.8%, 11.7%, 5.0% of patients in Group LS and 89.2%, 4.2%, 3.3% of patients in Group CL. There were no significant differences between the two groups (P>0.05). The parameters (SP, DP, MAP, HR) using Lighted Stylet underwent to significant changes at three periods (P>0.05). But those changes using conventional laryngoscopy were significant (P<0.05). No significant injuries to oral cavity occured in patients of Mallampati I～II in both groups, but injuries to oral cavity of patients of Mallampati III～IV were more significant in Group LS than in Group CL. Conclusions: Compared with conventional laryngoscopy, tracheal intubation using Lighted Stylet is safer,more valid and causes less injury.