光棒联合新型喉罩与纤维支气管镜气管插管临床效果比较

Comparison of clinical efficacy between laryngeal mask combined with new lightwand tracheal intubation and fiberoptic bronchoscopy

目的：比较光棒联合新型喉罩气管插管与纤维支气管镜气管插管的临床效果。方法选择100例接受光棒联合新型喉罩气管插管全身麻醉的患者100例为观察组，同期接受纤维支气管镜气管插管患者100例为对照组。观察两组不同等级气道插管情况（ Mallampati分级Ⅰ～Ⅳ级）及置管成功前后血流动力学变化，包括平均动脉压、血氧饱和度、心率、呼气末二氧化碳分压。比较两组插管时间及并发症发生情况。结果观察组Ⅳ级气道插管成功率为80.0％，显著高于对照组的36.4％，气管插管时间短于对照组，差异均有统计学意义（ P＜0.05）。气管插管置入后，观察组平均动脉压、心率、咽喉疼痛及口腔损伤的比例均低于对照组，差异有统计学意义（ P＜0.05）。两组血氧饱和度、呼气末二氧化碳分压比较差异均无统计学意义（ P＞0.05）。结论光棒联合新型喉罩气管插管成功率高，对血流动力学影响小，并发症少，值得临床推广应用。

Objective To compare the clinical effect of laryngeal mask combined with a new lightwand tracheal intubation to that of fiberoptic bronchoscopic endotracheal intubation.Methods One hundred patients received laryngeal mask combined with the new lightwand tracheal intubation during general anesthesia were designed as observation group,while another 100 patients received fi-beroptic bronchoscopic endotracheal intubation were designed as control group.Different grades of airway intubation（ Mallampati gradeⅠ~Ⅳ） and hemodynamic changes such as mean arterial pressure,heart rate,oxygen saturation,and end tidal carbon dioxide were ob-served before and after intubation.The intubation time and complications were compared between the two groups（P〉0.05）.Results The successful rate ofⅣairway intubation in the observation group was 80%that was significantly higher than that in the control group （36.4%）.The intubation time in the observation group was significantly shorter than that in the control group（P〈0.05）.The mean arterial pressure,heart rate,throat pain and injury rates after tracheal intubation in the observation group were significantly lower than that in the control group（all P〈0.05）.However,no significant difference in the oxygen saturation and end tidal carbon dioxide was found between the two groups.Conclusion The laryngeal mask combined with new lightwand tracheal intubation has higher success rate,less influence on hemodynamics and few adverse reactions.It is worthy of clinical application.