Airtraq光学可视喉镜联合Bougie探条或纤维支气管镜在气管插管中的应用

Application of airtraq optical laryngoscope with bougie or fiberoptic bronchoscope in tracheal intubation

目的观察全身麻醉下运用Airtraq光学可视喉镜暴露声门后,辅助使用探条或纤维支气管镜配合行气管插管的可行性。方法选取75例择期需行气管内插管手术的成年患者为研究对象,ASA评级Ⅰ~Ⅱ级,插管困难程度分级Ⅰ~Ⅱ级,随机分为Airtraq光学可视喉镜组、Airtraq光学可视喉镜辅助探条组（探条辅助组）和Airtraq光学可视喉镜辅助纤维支气管镜组（纤支镜辅助组）,每组各25例。比较三组不同方法的插管成功率,插管所需时间,以及有无麻醉后并发症。结果探条辅助组和纤支镜辅助组插管成功率显著高于Airtraq光学可视喉镜组（P〈0.05）;探条辅助组的插管时间显著短于Airtraq光学可视喉镜组和纤支镜辅助组（P〈0.05）;Airtraq光学可视喉镜组麻醉后并发症显著高于探条辅助组和纤支镜辅助组（P〈0.05）;结论 Airtraq光学可视喉镜辅助使用探条行气管插管成功率高,插管时间短,麻醉并发症少,适合临床使用。

Objective To investigate the feasibility of using alrtraq optical laryngoscope to expose glottis for tracheal intubation under general anesthesia conditions with the help of bougie or fiberoptic bronchoscopy. Method 75 adult patients with ASA ratingⅠ~Ⅱ and difficulty level of intubation （ Mallampati classification）Ⅰ~Ⅱrequiring tra-cheal intubation were selected and divided into 3 groups： the alrtraq optical laryngoscope group （25 cases）, the alrtraq optical laryngoscope with the help of bougie group （25 cases）, and the alrtraq optical laryngoscope with the help of fiberoptic bronchoscopy group （25 cases）; the success rate, time of intubation, and the incidence rate of anesthetic complications of different intubation methods were compared. Result The success rates of the alrtraq opti-cal laryngoscope with the help of bougie and the fiberoptic bronchoscope group were significantly higher than that of the alrtraq optical laryngoscope group （P〈0. 05）. The intubation time of the alrtraq optical laryngoscope with the help of bougie group was significantly less than that of the alrtraq optical laryngoscope group and the alrtraq optical laryngoscope with the help of fiberoptic bronchoscope group （P〈0. 05）. The incidence rate of anesthetic complica-tions in the alrtraq optical laryngoscope group was significantly higher than that of the alrtraq optical laryngoscope with the help of bougie group and the fiberoptic bronchoscopy group （P〈0. 05）. Conclusion Due to its high success rate, short intubation time and fewer anesthetic complications, combined application of alrtraq optical laryngoscope and bougie is a favorable choice in tracheal intubation.