Discoscope内窥镜于声门显露困难患者气管插管术后吞咽痛的临床观察

Observation of swallowing pain with disposcope endoscope in patients with difficult visible glottis

目的:观察Disposcope内窥镜与Macintosh喉镜对用于声门显露困难气管插管患者术后吞咽痛的影响。方法:择期行经气管插管全麻患者36例,Macintosh喉镜显露Cormach-Lehane分级Ⅲ或Ⅳ级,随机分为两组(n=18),Disposcope内窥镜组(D组)和Macintosh喉镜(M组)。记录声门显露率、插管成功情况和拔管后30 min、1、3 d吞咽痛VAS评分。结果:与M组相比,D组声门成功显露率与1次插管成功率明显增加(P<0.05);拔管后1 d,M组患者吞咽痛VAS评分高于D组(P<0.05);其余指标比较差异未见统计学意义(P>0.05)。结论:与Macintosh喉镜相比,Disposcope内窥镜用于声门显露困难患者气管插管可减少插管时间,提高1次插管成功率,有效降低术后患者吞咽痛的发生。

Objective To observe the influence of post-operative swallowing painwith Disposcope endoscope or Macintosh laryngoscope in patients with difficult visible glottis. Methods Thirty-six patients scheduled for elective surgery under general anesthesia whose glottis was not visible underMaeintosh laryngoscope （according to Cormach-Lehane Grading of laryngoscopic view） were randomized into 2 groups （n = 18 each） ： Disposcope endoscope group （group D） and Macintosh laryngoscope group （group M）. The rate of glottis exposure and successful intubation, swallowing pain at 30 rain, 1, 3 d after extubation were observed. Results Compared with group M, the successful rate of glottis exposure and first intubation was significantly higher than thatin group D （P 〈 0.05）. Swallowing pain VAS was higher in group M than in group D at ld afterextubation （P 〈 0.05）. Conclusions Compared with Macintosh laryngoscope, Disposcope endoscope in patients with difficult visible glottis could induce higher successful rate of glottis exposure and first intubation, shorter time of intubation and lower VAS of swallowing pain at ld after extubation.