Shikani可视软镜在气管导管更换中的临床应用

Clinical Application of Shikani Visible Soft Laryngoscope in Tracheal Tube Replacement

目的研究Shikani可视软镜在气管导管更换中的临床应用。方法选择术中需要进行气管导管更换的患者42例,ASAⅠ~Ⅱ级,年龄18~66岁。其中男性32例,女性10例;手术类型:耳鼻喉手术18例,口腔手术16例,颈椎手术8例。42例患者随机分为Shikani组(S组)和插管探条组(C组),每组21例。记录两组更换气管导管的所需时间(从开始置入管芯至连接麻醉机)、一次插管成功率、换管所致的并发症、血流动力学变化。结果两组患者换管均能一次完成。在换管时间上S组较C组耗费时间较多,两组比较有统计学意义。在使用纤支镜检查导管位置时发现C组有6例导管前端触及隆突,而需要调整导管深度。因两组患者换管时均在麻醉状态下完成,所以换管时并未出现明显的血流动力学变化。结论 Shikani可视软镜在气管导管更换的使用中具有方便快捷,全程可视,不易打折等优点,为临床更换气管导管提供多一种手段,应当成为麻醉科和其他临床科室换管的常备设备。

Objective To study the clinical application of Shikani visible soft laryngoscope in tracheal tube replacement. Methods We selected forty - two patients with phase I - II ASA, aged 1 8 - 6 6 years, male 32 and female 10 in the study. Types of operation involved 18 cases of ENT surgery, 16 cases of oral surgery and 8 cases of cervical spine surgery. The patients were randomly divided into Shikani group （ group S ） and intubation introducer group （ group C ） . The two groups were compared in terms of the time for replacing the tracheal catheters （ from inserting the tracheal tube core to connecting the anesthesia machine） , one - time success rates of intubation, complications due to tracheal tube replacement and changes in hemodynamics. Results The replacement of tubes was completed at one time in both two groups. The time for replacement in group S was significantly longer than that in group C. When checking the location of the tubes with bronchoscopy, we found its distal end reached the carina in 6 cases of group C , and then adjusted the d epth. The tracheal tube replacement in two groups was completed under anesthesia and there were no significant hemodynamic changes during replacement. Conclusions Shikani visible soft laryngoscope has many advantages such as convenience, full view, no easiness to fold in process of tracheal tube replacement and it can provide a mean for replacement of tracheal tube , Shikani visible soft laryngoscope should be a common device for tracheal tube replacement in anesthesia and other clinical departments.