Cookgas和Fastrach插管型喉罩联合光索在预测重度困难气道管理中的应用

The Application of Cookgas and Fastrach Intubations Laryngeal with Fiberoptic Bronchoscope in the Prediction of Severe Difficult Airway Management

目的探索Cookgas和Fastrach插管型喉罩联合光索在预测重度困难气道管理中的应用,为临床处理重度困难气道管理的问题提供依据。方法本院选择于2016年1月至2016年12月接受治疗的预测重度困难气道患者104例作为观察对象,按数字表法分为Cookgas插管型喉罩联合光索组(CILA组)和Fastrach插管型喉罩联合光索组(FT-LMA组),每组52例,并对两组患者的临床资料、手术之前的困难气道评估及声门的暴露情况进行分析。结果两组一般临床资料(年龄、性别、体重及身高)相比的差异没有统计学意义(t=1.562,P=0.092;χ2=1.448,P=0.104;t=1.520,P=0.081;t=1.604,P=0.095)。CILA组的张口度明显小于FT-LMA组,并且差异具有统计学意义(t=3.935,P=0.002);CILA组的Mallampti分级Ⅲ级之上的例数明显多于FT-LMA组,并且差异具有统计学意义(χ2=4.852,P=0.004);CILA组的预测困难面罩通气例数明显多于FT-LMA组,并且差异具有统计学意义(χ2=4.276,P=0.001)。CILA组4级声门的暴露例数显著低于FT-LMA组,且差异有统计学意义(χ2=4.921,p=0.003)。结论应用CILA和FT-LMA在预测重度困难气道管理中具有高效安全的功效,CILA插管的成功率更高,操作更为便捷,具有较高的临床应用价值。

Objective To explore the application of Cookgas and Fastrach intubationsLaryngeal with Fiberoptic Bronchoscope in the prediction of severe difficult airway management, providing the basis for clinical treatment of severe and difficult airway management.Methods A total of 104 cases with severe difficult airway in the hospital from Jan.2016 to Dec. 2016 were recruited as the study objects. The patients were divided into the Cookgas intubation laryngeal mask joint optical cable group(CILA group) and type Fastrach intubation laryngeal mask joint optical cable group(FT-LMA group) according to the number table method, 52 cases in each group. The indexs were analyzed mainly on the clinical data, and the difficulty of airway evaluation of patients before surgery, and the effect of exposure of the glottis in the two groups.Results There was no statistically significant difference between the two groups in general clinical data(age, gender, weight and height)(t=1.562,P=0.092;χ^2=1.448,P=0.104;t=1.520, P=0.081;t=1.604, P=0.095).The opening degree in the CILA group was significantly smaller than that in the FT-LMA group, and the difference was statistically significant(t=3.935, P=0.002).Mallampti class Ⅲ in the CILA group wassignificantly more than in the FT-LMA group, and the difference was statistically significant(χ^2=4.852,P=0.004).The number of ventilation cases with severe difficult airway in the CILA group was significantly higher than that in the FT-LMA group, and the difference was statistically significant(χ^2=4.276, P=0.001).The number of the cases with exposure of level 4 glottis in CILA group was significantly lower than that in the FT-LMA group, and the difference was statistically significant.(χ^2=4.921,p=0.003).Conclusion CILA and FT-LMA have high efficiency and safety in predicting severe difficult airway management. CILA intubation has higher success rate, easier operation and higher clinical value.