不同管芯位置下Glidescope可视喉镜气管插管的对比研究

A comparative study on the different locations of stylet using in tracheal intubation by glidescope videolaryngoscopy

目的比较在Glidescope可视喉镜下GlideRite管芯置入位置差异对气管插管时间、成功率、导管过声门阻力以及气道损伤指标的影响。方法选择60例全麻下行择期手术的患者,随机分为A组和B组两组,每组30例。常规麻醉诱导后,A组和B组分别将GlideRite管芯置于距离气管导管尖端2 cm和0.5 cm处,使用Glidescope可视喉镜实施经口气管插管。分别记录两组的喉部显露Cormark-Lehane分级、气管插管操作时间、插管成功率、导管过声门阻力、黏膜牙齿损伤发生率及术后咽痛声嘶评分。结果两组气管插管一次成功率均为100%,插管时间无统计学差异。与A组相比,B组气管插管时导管过声门阻力分级2级(轻微阻力)以上的例数明显增多,差异具有统计学意义(P<0.05)。两组术后声嘶咽痛的发生率均较低,B组略高于A组,但差异无统计学意义(P>0.05)。结论采用Glidescope可视喉镜经口气管插管时,将GlideRite管芯在气管导管内的位置后退2 cm能减轻气管插管过声门阻力,降低插管难度。

Objective To compare the time,successful rate,resistance and airway complications of tracheal intubation of Gliderite stylet at different localities for Glidescope videolaryngoscopy. Methods 60 patients undergoing general anesthesia required tracheal intubation were ran-domly divided into two groups：group A and group B. After routine anesthetic induction,orotracheal intubation was performed with tracheal tube at the Gliderite stylet 2 cm（group A）or 0. 5 cm（group B）away from the tip by the Glidescope videolaryngoscope. The duration,number of times, successful rate of tracheal intubation,the resistance of passing through glottis,the Cormack - Lehane grade and the airway complications were re-corded. Results One - time tracheal intubation had been succussful in all patients. The time for tracheal intubation was different but the differ-ence was not statistically significant. The number of patients with light resistance in tracheal intubation in group B was significantly larger than that of patients in group A（ P 〈 0. 05）. The rates of post - operative hoarseness and pharyngalgia were rare in these two groups,even the number of patients in group B was little bid larger,but the difference was not statistically significant. Conclusion The orotracheal intubation of Glidescope videolaryngoscopy is easily performed when the GlideRite stylet is backward for 2 cm in distance,thus it can reduce the resistance.