弹性橡胶管芯技术用于困难气道行双腔气管导管插管的可行性研究

Study on the Feasibility of Gum Elastic Bougie used for Double-Lumen Endotracheal Intubation in Difficult Airway

目的:研究弹性橡胶管芯技术应用于困难气道行双腔气管导管插管的可行性。方法:选择择期胸科手术并行双腔气管导管插管患者40例,并将其随机分为Mc Coy喉镜组(M组)和弹性橡胶管芯组(B组)。M组患者使用Mc Coy喉镜行双腔气管插管,B组患者以弹性橡胶管芯行双腔气管插管。观察和比较插管前后两组患者生命体征的变化、插管次数、所用时间以及由插管造成的损伤发生率。结果:1插管后即刻以及插管后1 min、5min,患者平均动脉压(MAP)、心率(HR)均呈不同程度升高,B组升高程度明显小于M组(P<0.01)。2B组插管时遇到的阻力明显小于M组(P<0.05),插管尝试次数以及完成插管所用的时间均少于或短于M组(P<0.05)。3术后3小时以及24小时,B组由插管导致的声嘶与咽痛的发生率明显低于M组(P<0.05)。4术后48小时,B组患者气道粘膜损伤的发生率明显低于M组(P<0.05)。结论:弹性橡胶管芯技术应用于困难气道行双腔气管导管插管安全有效。

Objective：To study the feasibility of gum elastic bougie applied in double-lumen endotracheal tube difficulty airway intubation.Methods：40 patients who needed double-lumen endotracheal intubation before elective thoracic operation,were selected and randomly divided into McCoy laryngoscope group（Group M） and gum elastic bougie group（Group B）.Group M was treated by McCoy laryngoscope to manage the double-lumen endotracheal intubation,while Group B was given the gum elastic bougie for double-lumen endotracheal intubation.Before and after tracheal intubation,the changes of vital signs of patients,attempts times,duration of intubation and incidence of damage caused by intubation were observed and compared between two groups.Results：① Just after intubation and 1min,5min after intubation,the MAP,HR of two groups both increased to different degrees,which were more significanltly in group M than those of group B（P〈0.01）.②The resistance caused by intubation,in Group B was obviously less than that of Group M（P〈0.05）,the intubation attempts and completion time for intubation were less than those of Group M（P〈0.05）.③3 hours and 24 hours after surgery,the patients were gived a return visit and found the incidence of hoarseness and sore throat caused by intubation of Group B was significantly lower than that of Group M（P〈0.05）.At 48 hours postoperation,the incidence of airway mucosal injury was obviously lower of Group B than that of Group M（P〈0.05）.Conclusion：To use gum elastic bougie manage the double-lumen endotracheal intubation in difficult airway was a safe and effective method.