不同手法辅助可视型内窥镜经口气管插管的临床应用

Clinical Application of Disposcope-guided Intubation With Different Aided Methods

目的评价不同手法辅助可视型内窥镜(帝视内窥镜)气管插管的临床应用价值。方法选择ASA分级Ⅰ或Ⅱ级的全麻患者60例,采用随机数字法,随机分为2组(n=30):单手提下颌组(对照组)和双手托下颌组(观察组)。对照组由单人提下颌手法辅助帝视内窥镜引导插管;观察组由助手双手托下颌手法辅助帝视内窥镜引导插管。记录一次气管插管成功率和总成功率,以及气管插管相关并发症。结果观察组插管成功率高于对照组,插管时间比对照组明显缩短,差异有统计学意义(P<0.05);对照组有5例操作者拇指留有患者齿印,但无出血,差异有统计学意义(P<0.05);对照组中有2例牙龈出血,观察组均无口腔牙龈出血,两组患者术后咽喉部痛等并发症比较差异无统计学意义(P>0.05)。结论双手托下颌手法辅助帝视内窥镜经口气管插管,可以缩短插管时间,提高气管插管成功率,减少损伤,且在困难气管插管中具有一定优势。

Objective To evaluate the clinical application value of Disposcope-guided intubation with different aided methods. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing general anaesthesia, were randomly divided into 2 groups （n = 30 each）： Mandibular process with single hand （A group） and Mandibular process with both hands （group B）. A group was treated by the single person to lift the lower jaw, and the B group was guided by the assistant of the hand .The success rate of intubation at first attempt, total success rate of intubation, and the related complications of tracheal intubation were recorded. Results The success rate of B group was higher than that of A group, the intubation time was lower than that of A group, the difference was statistically significant （P〈0.05）. In A group, there were 5 cases of patients with the thumb, but no bleeding; the difference was statistically significant （P〈0.05）. There were 2 cases of gingival bleeding in A group, there was no bleeding in the B group, and there was no significant difference between the two groups in postoperative sore throat pain （P〉O.05）. Conclusion With the aid of manipulateon process of the hand, the intubation time can be shortened, the success rate of intubation be improved, the injury be decreased, damage be reduced .It has certain advantages in the difficult tracheal intubation.