GlideScope视频喉镜在困难气道患者气管插管术中的临床应用价值和安全性评估

Clinical application value and safety evaluation of GlideScope video laryngoscope in endotracheal intubation of patients with difficult airway

目的评价GlideScope视频喉镜对困难气道患者进行气管插管术的临床应用价值。方法选择2014年7月至2015年7月在该院就诊的困难气道患者40例,随机分为GlideScope视频喉镜组(研究组)和Macintosh直接喉镜组(对照组),每组各20例。比较两组患者喉部Cormack-Lehane分级、气管首次插管成功率、插管操作时间、插管后损伤,记录麻醉诱导前(T_0)、诱导后(T_1)和插管即刻(T_2)各时间点的心率(HR)、平均动脉压(MAP)和脉搏血氧饱和度(SPO_2)。结果研究组喉部Cormack-Lehane分级高分级者显著低于对照组(P<0.05);研究组首次插管成功率明显高于对照组(P<0.05);研究组插管时间明显短于对照组(P<0.05);研究组无插管后损伤的情况,优于对照组;研究组患者T_2时与T_0时比较,血流动力学指标差异无统计学意义(P>0.05)。结论 GlideScope视频喉镜可安全用于困难气道的气管插管,显著降低喉部Cormack-Lehane分级,提高首次插管成功率且缩短插管时间,插管后损伤小,并对循环系统影响轻微,有较高的临床应用价值。

Objective To evaluate the clinical application value of GlideScope video laryngoscope in endotracheal intubation of the patients with difficult airway.Methods Forty patients with difficult airway in our hospital from July 2014 to July 2015 were selected and randomly divided into the GlideScope video laryngoscope group（research group）and the Macintosh direct laryngoscope group（control group）for performing endotracheal intubation,20 cases in each group.The laryngeal Cormack-Lehane grades,first time success rates of intubation,intubation time and injury after intubation were compared between the two groups.Heart rate（HR）,mean arterial pressure（MAP）and pulse oxygen saturation（SPO_2）were also recorded at the time points of before induction（T_0）,after induction（T_1）,and immediate intubation（T_2）.Results The patients with laryngeal high Cormack-Lehane grades in the research group were significantly lower than those in the control group（P0.05）;the intubation success rate in the research group was obviously higher than that in the control group（P0.05）;the intubation time in the research group was significantly shorter than that in the control group（P0.05）;no injury was observed after intubation,which was superior to the control group;the hemodynamic indicators in the research group had no statistical difference between at T_2 and T_0（P0.05）.Conclusion The GlideScope video laryngoscope can be safely used for the patients with difficult airway,obviously reduces the laryngeal Cormack-Lehane grades,increases the first time intubation success rate and shortens the intubation time with little injury after intubation,slight influence on circulation system and higher clinical application value.