HC可视喉镜在急诊肥胖患者紧急气管插管时的应用

The application of HC visual laryngoscope used for emergency tracheal intubation on obese patients in Emergency Department

目的探索HC可视喉镜用于急诊科肥胖患者紧急气管插管的作用和应用价值。方法选取2014年1月至2016年12月期间需要进行紧急气管插管就诊于西安交通大学第二附属医院急诊科就诊的肥胖患者,共计80例,随机(随机数字法)分为传统光学喉镜组(T组)和HC可视喉镜组(HC组),分别采用传统光学喉镜和HC可视喉镜进行气管插管,比较两组的声门暴露成功率、插管尝试次数、插管时间、插管成功率以及并发症发生率。两组间比较采用LSD-t检验或χ^2检验。结果HC组的声门暴露成功率为95%,高于T组(77.5%),差异有统计学意义(P<0.05);HC组的一次插管成功率、总插管成功率分别为72.5%、95%,均高于T组(37.5%、62.5%),差异均有统计学意义(P<0.05)。HC组成功插管病例的尝试次数和插管时间分别为(1.26±0.40)次、(30.74±6.17)s,均少于T组(1.64±0.82)次、(44.2±7.68)s,差异均有统计学意义(P<0.05)。HC组的并发症发生率为12.5%,低于T组(35%),差异有统计学意义(P<0.05)。结论使用HC可视喉镜为肥胖患者进行紧急气管插管,不仅可以提高声门暴露成功率、提高插管成功率,还可以减少插管的尝试次数和时间,而且可以减低插管并发症发生率,具备一定的应用价值。

ObjectiveTo investigate the effect and application value of HC visual laryngoscope used for the emergency tracheal intubation on obese patients in the Emergency Department.MethodsTotally 80 obese patients enrolled from January 2014 to December 2016 from Emergency Department, Second affiliated hospital of Xi'an Jiaotong University who needed the emergency tracheal intubation were randomly (random number) divided into two groups. Patients in group T were operated with traditional laryngoscope, and patients in group HC with HC visual laryngoscope. Then the success rate of glottis exposure, the trial times, operative time, success rate and complication rate of tracheal intubation were compared between the two groups.ResultsThe success rate of glottis exposure in group HC was significantly higher than that in group T (95% vs 77.5%, P<0.05). The one-time success rate of tracheal intubation and the total success rate of tracheal intubation in group HC were significantly higher than those in group T (72.5% vs 37.5%, and 95% vs 62.5%, respectively, P<0.05). However, the trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in group T (1.26±0.40) vs (1.64±0.82), and (30.74±6.17) s vs (44.2±7.68) s, respectively, P<0.05. The complication rate of tracheal intubation in group HC was significantly less than that in group T (12.5% vs 35%, P<0.05).ConclusionsHC visual laryngoscope used for the obese patients in Emergency Department can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation, thus having a certain application value.