Clarus可视喉镜硬镜与Macintosh喉镜在气管插管临床应用的比较

Comparison of Clinical Application of Clarus Visual Laryngoscope Hard Lens and Macintosh Laryngoscope in the Trachea Cannula

目的探讨Clarus可视喉镜硬镜与Macintosh喉镜应用于全麻气管插管中的临床价值。方法方便选取新疆石河子市人民医院麻醉科2013年10月—2014年3月所收治非颌面头颈部气管插管全麻手术患者120例,随机分为研究组和对照组。研究组60例,采用Clarus可视喉镜硬镜插管;对照组60例,采用Macintosh喉镜插管。比较两组口唇、牙齿以及咽喉部组织损伤程度、插管成功率、术后并发症发生情况及不同时刻血流动力学改变情况。结果研究组声门暴露良好率为100.00%,显著优于对照组83.33%,差异有统计学意义(P<0.01)。研究组气管插管成功率为96.67%,显著优于对照组的78.33%,差异有统计学意义(P<0.01);研究组气管插管时间为(31.54±19.25)s,显著高于对照组的(54.17±25.32)s,差异有统计学意义(P<0.01)。研究组组织损伤发生率为11.67%,低于对照组的28.33%,差异有统计学意义(P<0.05)。两组患者插管前MAP、HR差异无统计学意义(P>0.05);研究组T1、T2、T3、T4时刻MAP、HR变化均低于对照组,差异有统计学意义(P<0.05)。结论与Macintosh喉镜相比较,Clarus可视喉镜可有效改善声门暴露程度、缩短气管插管操作时间、提升插管成功率、减少组织损伤、减少机体应激反应,临床应用价值显著。

Objective To discuss the clinical value of Clarus visual laryngoscope hard lens and Macintosh laryngoscope in the trachea cannula. Methods Convenient selection 120 cases of patients from October 2013 to March 2014 with tracheal intubation general anesthesia admitted and treated in the department of anesthesiology in our hospital were randomly divided into two groups with 60 cases in each, the research group adopted the Clarus visual laryngoscope hard lens, while the control group adopted the Macintosh laryngoscope, and the lips, teeth, tissue injury degree in the pars laryngea pharynges, intubation tube success rate, occurrence of postoperative complications and changes of haemodynamics at different time points were compared between the two groups. Results The good rate of glottis exposing in the research group was obviously lower than that in the control group（100.00% vs 83.33%）, and the difference had statistical significance（P〈0.01）, the success rate of trachea cannula in the research group was obviously better than that in the control group（96.67% vs 78.33%）, and the difference had statistical significance（P〈0.01）, and the trachea cannula time in the research group was obviously higher than that in the control group[（31.54±19.25）s vs（54.17±25.32）s], and the difference had statistical significance（P〈0.01）, and the incidence rate of tissue injury in the research group was lower than that in the control group（11.67% vs 28.33%）, and the difference had statistical significance,（P〈0.05）, and the differences in the MAP and HR before the cannula had no statistical significance（P〈0.05）, and the MAP and HR changes at T1,T2,T3,T4 in the research group were lower than those in the control group, and the differences had statistical significance（P〉0.05）. Conclusion Compared with Macintosh laryngoscope, the Clarus visual laryngoscope can effectively improve the Glottis exposure degree, shorten the operation time of tracheal intubation, improve the success rate of cannula, reduce the tissue injury and reduce the organism stress, which is of obvious clinical application value.