HC视频喉镜与传统Macintosh喉镜用于麻醉气管插管的效果对比观察

The effects comparison of HC video laryngoscope and traditional macin-tosh laryngoscope for endotracheal intubation anesthesia

目的比较HC视频喉镜与传统Macintosh喉镜用于麻醉气管插管的效果。方法选择我院2013年5月~2014年5月收治的拟行全身麻醉困难气道气管插管的手术患者90例,按随机数字表法分为H组和M组,各45例。H组行全麻HC视频喉镜经口气管插管,M组行全麻传统Macintosh直接喉镜经口气管插管,比较两组患者的声门暴露时间、插管次数、失败例数、镜下C-L分级及血流动力学变化。结果与M组比较,H组声门暴露情况（C-L分级）更好（P〈0.05）,声门暴露时间更长（P〈0.05）;与T1相比,T2时两组SBP、DBP和MAP均显著下降（P〈0.05）;与T2相比,T3、T4时的血压均显著升高（均P〈0.05）;H组T3时血压升高程度显著低于M组（P〈0.05）;T4后随着时间的推移血压逐渐下降,T5、T6时两组血压均高于诱导后水平（均P〈0.05）。与T1相比,T2时两组患者HR均无明显改变;与T2相比,H组患者的HR在T3及T4时并无明显改变,M组HR在这两个时点显著上升（均P〈0.05）,且明显高于H组同时间点的HR水平（均P〈0.05）。M组在T5时,HR仍较高（P〈0.05）,直至T6后才恢复至T2水平。结论 HC视频喉镜引导经口气管插管不增加血流动力学波动且可提供更好声门显露,可安全应用于临床气管插管操作。

Objective To compare the effect of HC video laryngoscope and traditional Macintosh laryngoscope for endo- tracheal intubation anesthesia. Methods Selected 90 patients who were treated in our hospital from May 2013 to May 2014 were going to be treated with endotracheal intubation of general anesthesia surgery. According to the random number table method, they were randomly divided into group H and group M, 45 cases in each group. Group H re- ceived HC video laryngoscope for endotracheal intubation with general anesthesia, while group M was undergone tradi- tional Macintosh direct laryngoscope for endotracheal intubation with general anesthesia. The glottis exposure time, in- tubation times, the number of cases of failure, the classification of microscopic C-L and hemodynamic changes of two groups were compared. Results Compared with group M, glottis exposure situation （C-L hierarchical） of group H was better （P〈0.05）, but the glottis exposure time was longer （P〈0.05）. When compared with T1, SBP, DBP and MAP of two groups were significantly decreased at T2（P〈0.05）. Compared with T2, the blood pressure were elevated significantly at T3 and T4 （P〈0.05）. The elevating level of blood pressure of group H at T3 was significantly lower than that of group M （P〈0.05）. With time going by, blood pressure gradually declined after T4, and at T5 and T6, the level of blood pressure of two groups was higher than that after induction （all P〈0.05）. Compared with T1, HR of two groups of patients at T2 had no obvious change. Compared with T2, HR of group H at T3 and T4 had no obvious change, but that of group M was significantly increased （all P〈0.05）, and the level of HR was significantly higher than that of group H at the same point （all P〈0.05）. The level of HR in group M was still higher at the time of the T5（P〈0.05）, and that came back to T2 level until after T6. Conclusion It does not increase the hemodynamic fluctuations and can provide better glottis exposure to use HC video laryngoscope for endotracheal intubation, therefore it can be safely applied to clinical endo- tracheal intubation.