Ambu Aura-i喉罩联合纤维支气管镜用于鼾症患者气管插管的临床观察

Clinical observation on Ambu Aura-i laryngeal mask combined with fiberoptic bronchoscope for tracheal intubation in snore symptom patients

目的观察Ambu Aura-i喉罩联合纤维支气管镜(FOB)引导气管插管在鼾症患者中应用的可行性。方法 40例符合条件的鼾症患者,随机分为F组(FOB引导)和L组(盲探),各20例。麻醉诱导后置入喉罩,经喉罩由FOB引导插管或盲探插管。记录喉罩置入及气管插管的次数和时间,以及麻醉诱导前基础值(T0)、麻醉透导后(T1)、置入喉罩后(T2)、插管即刻(T3)的收缩压(SBP)、舒张压(DBP)和心率(HR);观察喉罩退出时是否带血迹并随访术后患者不良反应。结果两组首次喉罩置入成功率比较差异无统计学意义(P>0.05)。F组气管插管总成功率100%高于L组75%,差异具有统计学意义(P<0.05)。F组首次插管成功时间及二次插管成功时间均短于L组,差异均具有统计学意义(P<0.05)。两组T3时点SBP、DBP和HR均较T1明显升高,差异均具有统计学意义(P<0.05),但与T0比较差异无统计学意义(P>0.05)。两组间各时点SBP、DBP和HR比较差异无统计学意义(P>0.05)。L组拔出喉罩后带血6例,术后咽痛5例;F组拔出喉罩后带血3例,术后咽痛1例。F组不良反应发生情况少于L组,差异具有统计学意义(P<0.05)。结论 Ambu Aura-i喉罩联合FOB用于鼾症患者气管插管成功率高、效果好且不良反应少。

Objective To observe feasibility of Ambu Aura-i laryngeal mask combined with fiberoptic bronchoscope（FOB） for tracheal intubation in snore symptom patients. Methods A total of 40 eligible patients with snore symptom were randomly divided into group F（FOB guiding） and group L（blind exploring）, with 20 cases in each group. The laryngeal mask was placed after anesthesia induction, guiding by FOB for intubation or blind intubation by laryngeal mask. Record were made on times and duration in laryngeal mask placement and tracheal intubation, systolic blood pressure（SBP）, diastolic blood pressure（DBP） and heart rate（HR） at base value（T0） before anesthesia induction, after anesthesia induction（T1）, after laryngeal mask placement（T2）, immediate intubation（T3）. Whether there was blood or not when removal laryngeal mask was observed and follow-up reviewed postoperative adverse reactions in patients. Results There were no statistically significant difference in first successful intubation rate of laryngeal mask placement between two groups（P〈0.05）. Group F had higher total success rate in tracheal intubation as 100% than 75% in group L, and the difference had statistical significance（P〈0.05）. Group F had shorter first successful intubation time and second successful intubation time than those in the group L, and their differences had statistical significance（P〈0.05）. Both groups had higher SBP, DBP and HR at T3 point than T1 point, and the difference had statistical significance（P〈0.05）, but had no statistically significant difference compared with T0 point（P〉0.05）. Group L had 6 bloody cases after removal of laryngeal mask, 5 postopervative pharyngalgia cases, while 3 and 1 case in group F. Group F had less occurrence of adverse reactions than group L, and their difference had statistical significance（P〈0.05）. Conclusion Ambu Aura-i laryngeal mask combined with FOB shows high success rate, good curative effect and few adverse reactions for tracheal intubation in snore symptom patients.