帝视内窥镜引导全麻患者经鼻气管插管的临床应用

Clinical application of telescope endoscopic catheterization in patients with general anesthesia

目的探讨帝视内窥镜引导全麻患者经鼻气管插管的临床应用效果及价值。方法选取60例需要全麻的患者采用随机数字表分为对照组(30例,采用普通喉镜进行全麻)和研究组(30例,采用帝视内窥镜引导全麻)。对比麻醉前基础值(T1)、麻醉诱导后插管前(T2)、插管成功即刻(T3)及插管后1 min(T4)、插管后5 min(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)变化,记录并对比气管插管操作时间、术后气管插管所致的并发症情况。结果 SBP、DBP和HR时间、组间、交互作用对比差异均有统计学意义(P<0.05),其中研究组T2~T5时刻SBP、DBP和HR均明显高于对照组(P<0.05);本组内比较,研究组T2~T4时刻、对照组T2~T5时刻SBP、DBP和HR均低于T1时刻(P<0.05),T3时刻SBP、DBP和HR均低于T2时刻(P<0.05),T5时刻SBP、DBP和HR均高于T2时刻(P<0.05),T4和T5时刻SBP、DBP和HR均高于T3时刻(P<0.05),T5时刻SBP、DBP和HR均高于T4时刻(P<0.05);研究组气管插管操作时间明显短于对照组(P<0.05),且研究组术后气管插管所致的总并发症发生率为3.33%,远低于对照组的26.67%,对比差异有统计学意义(P<0.05)。结论采用帝视内窥镜引导全麻患者经鼻气管插管能够有效稳定生命体征指标,缩短气管插管操作时间,并且并发症较少,安全性更高。

Objective To investigate the clinical application and value of transsphenoidal intubation in patients undergoing endoscopic guidedgeneral anesthesia. Methods Sixty patients requiring general anesthesia were randomly divided into the control group （30 patients, general anesthesiawith general laryngoscope） and the study group （30 patients with general anesthesia guided by the endoscope）. Contrast basal values （T1） beforeanesthesia, pre-intubation （T2） after anesthesia induction, immediate intubation （T3）, and 1 min （T4） after intubation, and 5 min （T5） systolic bloodpressure （SBP） after intubation, Diastolic blood pressure （DBP）, heart rate （HR） changes, recording and comparison of tracheal intubation operation time, postoperative complications caused by tracheal intubation. Results There were significant differences in SBP, DBP and HR time, group and interaction（P〈0.05）. The SBP, DBP and HR of T2-T5 in the study group were significantly higher than those in the control group （P〈0.05）. In thisgroup, SBP, DBP and HR were lower than T1 （P〈0.05） at T2-T4 and T2-T5 in the control group, and SBP, DBP and HR were lower than T2 at T3 （P〈0.05）. At the time of T5, SBP, DBP and HR were higher than T2 （P〈0.05）, SBP, DBP and HR were higher than T3 at T4 and T5 （P〈0.05）, and SBP,DBP and HR were higher than T5. At the time of T4 （P〈0.05）; the operation time of tracheal intubation in the study group was significantly shorterthan that in the control group （P〈0.05）, and the total complication rate of tracheal intubation in the study group was 3.33%, which was much lowerthan that of the control group26.67%. The difference was statistically significant （P〈0.05）. Conclusion Trans-tracheal intubation of patients withgeneral anesthesia guided by Dimensional endoscopy can effectively stabilize vital signs, shorten the operation time of tracheal intubation, and havefewer complications and higher safety.