颈椎活动受限患者三种插管方式的效果比较

Comparison of three intubation methods in patients with restricted cervical movement

回顾性分析我院2012年6月到2014年6月进行的96例伴颈椎活动受限全身麻醉气管插管患者的临床资料。均采用相同麻醉诱导，其中行纤维支气管镜（纤支镜）、视可尼喉镜和McCoy喉镜插管各32例。与McCoy喉镜相比，视可尼喉镜插管患者气管插管总成功率、一次成功率较高而插管时间较短，术后并发症率较低（均P〈0．05）。与纤支镜插管患者相比，视可尼喉镜插管患者的插管时间较短（P〈0．05），各时间点心率、平均动脉压及氧饱和度，气管插管总成功率、一次成功率及并发症率差异均无统计学意义（P〉0．05）。采用视可尼喉镜插管对血流动力学影响较小，且插管时间短，更适用于颈椎活动受限患者气管插管。

The clinical data of 96 intubated inpatients with restricted cervical movement from June 2012 to June 2014 were retrospectively reviewed. They were divided into fiberoptie bronchoscope, Shikani optical stylet and McCoy laryngoscope groups （n = 32 each ） . Identical anesthesia induction was applied. Compared with McCoy laryngoscope group, the total success rate and one-time success rate of tracheal intubation was higher in Shikani optical stylet group, tracheal intubation time was shorter and postoperative complications were fewer （ P 〈 0.05 ）. Compared with group F, endotracheal intubation time was shorter （P 〈 0. 05 ）. However, heart rate, mean arterial pressure （ MAP）, oxygen saturation （ SpO2 ）, total success rate of tracheal intubation, one-time success rate of tracheal intubation and complication rate showed no significant inter-group differences at all timepoints （ P 〉 0.05 ）. Shikani optical stylet intubation has a less impact on hemodynamics and intubation time is short so that it is ideal for surgical patients with restricted cervical spine.