Glidescope视频喉镜与Macintosh直接喉镜进行气管插管学习曲线的比较

Comparison of the students' learning curves between Glidescope and Macintosh laryngoscope in endotracheal intubation

目的比较Glidescope视频喉镜与Macintosh直接喉镜的学习曲线,确定哪一种让初学者更容易掌握、插管成功率更高。方法 15名实习医师经高年资麻醉医师培训后,在其监督指导下采用视频喉镜和直接喉镜,分别为6个需要全身麻醉的手术患者进行气管插管,其中每种喉镜为3个患者进行气管插管,分别为Glidescope视频喉镜组(G组)和Macintosh直接喉镜(M组),喉镜使用顺序由计算机产生的随机数字表决定。结果 90例准备在全身麻醉下接受手术的连续患者参加了本随机交叉对照研究,声门暴露Ⅰ级患者G组(88.9%)显著优于M组(57.8%);插管成功率G组(91.1%)明显高于M组(71.1%);插管难度评价NRSG组(1.7±0.9)分明显低于M组(2.6±0.7)分,以上各项指标比较差异均有统计学意义(P<0.05)。结论与Macintosh直接喉镜相比较,初学者采用Glidescope视频喉镜气管插管更容易暴露声门、插管成功率高、学习进步迅速。

Objective To compare medical students＇ learning curves between Glidescope and Macintosh laryngoscope in endotracheal intubation, and to decide which one is more suitable for a beginner. Methods Totally 15 interns after being trained by experienced anesthesiologists were enrolled in this study. They performed intubation on6 patients by using both Glidescope and Macintosh laryngoscope（each laryngoscope for 3 patients） under the supervision of experienced anesthesiologists, which were designated as Glidescope group（G group） and Macintosh laryngoscope（M group）, respectively. The sequence of laryngoscope was determined by computer-generated random number list.Results Totally 90 patients who were ready to receive surgery general anesthesia were enrolled in this randomized crossover controlled study. The glottis exposure in patients with grade Ⅰin G group（88.9%） was significantly better than that in M group（57.8%）. Intubation success rate was significantly higher in G group（91.1%） than that in M group（71.1%）. The evaluation of difficult intubation（Number rating scale） of G group [（1.7 ± 0.9）] was significantly lower than that of M group [（2.6±0.7）], P0.05. Conclusion With the advantages of rapid learning curve, easier to expose the glottis, higher intubation success rate, Glidescope is easier to master for a beginner compared with Macintosh.