Truview EVO_2喉镜与Macintosh喉镜用于颈椎活动受限患者气管插管的对比研究

Comparison Between Truview EVO_2 and Macintosh Laryngoscopes in Endotreacheal Intubation for Patients with Restricted Neck Movement

目的评价Truview EVO2喉镜与Macintosh喉镜用于颈椎活动受限患者气管插管的临床应用情况。方法择期颈椎活动受限经口气管插管全麻手术49例,静脉麻醉诱导后,随机先后使用Truview EVO2喉镜与Macintosh喉镜显露喉部,并采用喉部暴露条件好的喉镜行气管插管。比较2种喉镜Cormack-Lehane(C-L)分级,喉部结构显露时间和声门显露时血流动力学改变。结果 Truview EVO2喉镜组C-L分级显著优于Macintosh喉镜组(Z=-5.488,P=0.000),喉部结构显露时间明显长于Macintosh喉镜组[(15.9±6.7)s vs.(12.3±4.5)s,t=4.304,P=0.000]。2种喉镜声门显露时HR、SBP、MAP变化无统计学差异(P>0.05)。结论 Truview EVO2喉镜用于颈椎活动受限患者气管插管效果明显优于Macintosh喉镜,可提高气管插管成功率,对于部分困难气道患者具有较好的应用价值。

Objective To compare the clinical application between Truview EVO2 and Macintosh laryngoscopes in endotreachal intubation for patients with restricted neck movement. Methods Forty-nine patients scheduled for elective surgery under general anesthesia requiring orotracheal intubation were enrolled. After intravenous anesthetic induction, orotraebeal intubation was randomly performed by an experienced anesthesiologist with both Truview EVO2 and Macintosh laryngoscopes. Then the patient was intubated with the laryngoscope with better view. Parameters were recorded, including Cormack-Lehane （C-L） grade of laryngeal view, the laryngeal exposuring time, and hemodynamic changes during intnbation. Results Better C-L grade of laryngeal view was achieved in the Truview EVO2 laryngoscope as compared with the Macintosh laryngoscope （Z = - 5. 488, P = 0. 000）. The laryngeal exposuring time of Truview EVO2 laryngoscopy was longer than that of Macintosh laryngoscope [ （ 15.9 ＋ 6.7） s vs. （ 12.3 ~ 4.5） s, t =4. 304, P = 0. 000 ]. There was no significantly difference in hemodynamic changes between Truview EVO2 and Macintosh laryngoscopes（P 〉 0.05）. Conclusions In patients with limitation of neck movement, the Truview EVO2 laryngoscope is more feasible and effective than Macintosh laryngoscope in orotracheal intubalion. The Truview EVO2 laryngoscope is a valuable tool for managing difficult airway for restricted neck movements.