光棒辅助与普通喉镜气管插管用于颈椎骨折手术患者的比较

Comparation between lightwand and general laryngoscope application of trachea cannula in cervical spine fracture patients

目的比较光棒辅助与普通喉镜气管插管用于颈椎骨折全麻患者的插管效果和安全性。方法选择拟行气管插管全麻的颈椎骨折手术患者40例,男28例,女12例,年龄18~65岁,ASAⅡ或Ⅲ级,随机分为两组,每组20例。全麻诱导后,L组采用光棒引导气管插管,C组采用普通喉镜辅助气管插管。记录一次插管成功例数、插管时间,插管前5 min、插管即刻和插管后5 min的MAP和HR,以及插管时不良反应情况。结果 L组的一次性插管成功率明显高于C组（90%vs.60%）,插管时间明显短于C组[（31.3±11.1）s vs.（46.6±15.2）s]（P〈0.05）。与C组比较,L组患者插管期间MAP和HR变化更平稳。C组有4例（20%）心律失常,L组无一例心律失常。结论与普通喉镜比较,光棒引导气管插管用于颈椎骨折手术患者插管更容易,安全性更好。

Objective To compare the effect and safety between lightwand and general-laryngoscope application of trachea cannula in cervical spine fracture patients undergoing general anesthesia.Methods Forty cervical spine fracture patients with tracheal intubation anesthesia were selected,including twenty-eight males and twelve females,aged 18-65 years,ASA physical statusⅡorⅢ.These patients were randomly divided into two groups,twenty cases in each group.After anesthesia induction,group L was given general laryngoscope intubation,whereas group C was taken lightwand guided tracheal intubation.The success case of intubation at first,intubation time,adverse reaction of intubation,changes of MAP and HR at intubation and 5minutes after intubation were observed.Results Compared with group L,success rate of intubation at first was higher（90% vs.60%）,intubation time was shorter[（31.3±11.1）s vs.（46.6±15.2）s]in group C（P〈0.05）.The changes of MAP and HR were more stable during intubation in group C compared with group L.Four cases of arrhythmia（20%）occurred in group C,while none in group L.Conclusion Compared with intubation by general laryngoscope,application of tracheal intubation led by lightwand in cervical fracture patients is more effective and safer.