管芯引导法经口盲探气管插管术2300例分析

Analysis of 2300 cases of blind orotracheal intubation guided by catheter cores

目的探讨＂管芯引导法经口盲探气管插管术＂的可行性和临床价值。方法选取2013年7月至2015年3月接收＂管芯引导法经口盲探气管插管术＂的2 300例全麻患者作为研究对象,统计患者气道评估情况、气管插管时间、插管成功率、插管操作引起的并发症及插管心血管应激反应发生率。结果 2 300例患者中困难气道（WILSON综合评定〉5分）者386例,占16.8%;气管插管时间为8～90 s,平均（17±6）s;气管插管成功率为98.7%,困难气道插管成功率为92.0%,其中插管失败者经纤维咽喉镜辅助插管成功;插管操作并发症发生率为1.6%,插管心血管反应发生率为1.2%。结论管芯引导法经口盲探气管插管术无须麻醉喉镜及特殊设备辅助,操作简单,并发症少,安全可行,插管应激反应轻微,对于某些心脑血管疾病和插管困难患者有一定的临床应用价值。

Objective To investigate the feasibility and clinical value of ＂blind orotracheal intubation guided by catheter cores＂. Methods 2 300 patients received＂blind orotracheal intubation guided by catheter cores＂under general anesthesia from July of 2013 to March of 2015 were retrospected,and the assessment of airway,tracheal intubation time,success rate of intubation,the complications caused by intubation operation and the rate of cardiovascular stress response to intubation were collected.Results Among 2 300 cases,386 cases had difficult tracheal intubation,accounting for 16. 8%; the time of tracheal intubation was 8 ～ 90 s,with an average of（ 17 ± 6） s; the success rate of tracheal intubation was 98. 7%; the success rate of difficult tracheal intubation was 92. 0%; the rate of complications caused by intubation operation was 1. 6%; the rate of cardiovascular stress response to intubation was 1. 2%. Conclusion ＂Blind orotracheal intubation guided by catheter cores＂has the merits of no anesthesia laryngoscope,no special auxiliary equipment,simple operation,less complications,safe and feasible,mild response to intubation. It has a certain clinical value for patients with cardiovascular and cerebrovascular diseases or difficult intubation.