HC可视喉镜在非麻醉专业住院医师气管插管中的应用

The Application of HC Video Laryngoscope in Tracheal Intubation by Novice Nonanesthesia Residents

目的:评估HC可视喉镜在已完成麻醉规范化培训的非麻醉专业住院医师气管插管中的应用效果。方法:32名完成麻醉规范化培训的非麻醉专业住院医师,每人使用HC可视喉镜及Macintosh喉镜分别实施3例非困难气道气管插管。记录首次气管插管成功率、首次成功插管所用时间、Cormack-Lehane评分、总体插管成功率、导管误入食道发生率以及总体并发症发生率。结果:HC可视喉镜组首次插管成功率明显高于Macintosh喉镜组(98%vs 78%,P<0.05);首次成功插管用时明显短于Macintosh喉镜组[(51.2±0.8)秒vs(59.2±0.7)秒,P<0.05]。在每病例最多两次插管尝试研究设定下,住院医师总体插管成功率在HC可视喉镜组明显高于Macintosh喉镜组(100%vs 85%,P<0.05)。导管误入食道发生率明显低于Macintosh喉镜组(1%vs 26%,P<0.05)。结论:非麻醉专业住院医师接受麻醉规范化培训后,可使用HC可视喉镜成功实施非困难气道气管插管;和传统使用Macintosh喉镜行气管插管比较,具有成功率高、耗时短等优点。

Objective：To evaluate the effectiveness of the application of HC video laryngoscope in tracheal intubation by novice non-anesthesia residents. Methods：32 non-anesthesia residents who had finished 1-month tracheal intubation training during their rotation in the department of anesthesiology were enrolled and every one of them was asked to perform non difficult airway tracheal intubation for 6 cases with the adoption of HC video laryngoscope and traditional Macintosh laryngoscope. Besides the primary outcome of this study-the success rate of first tracheal intubation trial,the intubation duration,cormack-lehane classification,the overall success rate of tracheal intubation,the incidence of esophageal intubation and other complications were also recorded. Results：The success rate of first tracheal intubation trial in HC group was significantly higher than that of the macintosh group（98% vs 78%,P〈0.05）. The intubation duration in HC group was significantly shorter than that of the macintosh group[（51.2±0.8）sec vs（59.2±0.7）sec,P〈0.05]. The overall success rate of tracheal intubation in HC group was significantly higher than that of the macintosh group（100%vs 85%,P〈0.05）. The incidence of esophageal intubation in HC was lower than that of macintosh group（1% vs 26%,P〈0.05）. Conclusion：The application of HC video laryngoscope in tracheal intubation by novice non-anesthesia residents presents a higher success rate of first intubation trial and less intubation duration when compared with that of traditional Macintosh laryngoscope.