视可尼视频喉镜与Macintosh喉镜用于模拟颈椎损伤病人气管插管的对比观察

The comparative observation of Shikani in intubation for the patients with simulated cervical spine injury

目的对比观察视可尼(Shikani)视频喉镜和Macintosh喉镜用于Ambu颈托固定模拟颈椎损伤病人气管插管的临床效果。方法随机选取拟行择期手术需全身麻醉气管插管的80例患者,随机分为Shikani(S组,n=40)和Macintosh组(M组,n=40),麻醉诱导后,使用Ambu颈托固定颈椎,由熟练掌握该两种工具的同一麻醉医师完成气管插管,记录各组成功插管持续的时间、声门暴露时间、一次插管成功率、总插管成功率。记录并比较插管过程中心血管不良事件的发生次数。结果两组成功插管时间分别为30.65±8.22 s(S组)和42.48±8.32 s(M组),S组明显短于M组(P<0.05);S组插管期间的心血管不良事件发生次数(11次)明显低于M组(31次)(P<0.05);S组声门暴露时间(21.20±4.73 s)和一次插管成功率(97.5%)与M组(20.53±5.47 s,97.5%)比较,差异无统计学意义(P>0.05)。结论与Macintosh喉镜相比,Shikani视频喉镜用于Ambu颈托固定模拟颈椎损伤病人气管插管成功插管所需时间短,插管期间心血管事件发生率低,是安全有效的。

Objective To compare the clinical application of the Macintosh and Shikani in intubation for the patients with simulated cervi-cal spine injury using Ambu rigid collar. Methods 80 patients undergoing general anesthesia who required tracheal intubation were randomly as-signed to two groups：Shikani（S,n=40）and Macintosh（M,n=40）. After induction of anesthesia,the neck of the patients was immobilized with Ambu rigid collar,and the tracheal intubation was performed by an experienced anesthetist who was familiar with each of these two devices. The duration of the successful attempt and visualized glottis was recorded. The success rate for intubation in the first attempt and the overall success rate for intubation were recorded too. The number of cardiovascular adverse events during tracheal intubation were observed. Results The dura-tionofthesuccessfultrachealintubationattemptswas30.65±8.22s（S）and42.48±8.32s（M）respectively. Thereweresignificantdifference between two groups（ P 〈0. 05）. The number of adverse events of S group（11）was significantly lower than that in M group（31）（ P 〈0. 05）. The rate of the first successful tracheal intubation and the duration visualized glottis in two group did not show significantly difference between S group（21. 20 ± 4. 73 s,97. 5%）and M group（20. 53 ± 5. 47 s,97. 5%）（ P 〉0. 05）. Conclusion The duration of the successful tracheal intubation attempts and the number of cardiovascular adverse events during tracheal intubation of Shikani were shorter and lower compared with the Macintosh. Therefore,it is a safe and effective mean in the intubation for the patients simulated cervical spine injury using Ambu rigid collar.