HC可视喉镜配合UE可视软性喉镜在双腔支气管插管中的应用

Application of HC Video Laryngoscope Combined with UE Visual Soft Laryngoscope in Double Lumen Bronchial Intubation

目的探讨HC可视喉镜配合UE可使软性喉镜在双腔支气管插管中的应用效果。方法方便选取2014年3月—2018年3月在该院接受双腔支气管插管全身麻醉的胸外科手术的116例患者作为研究对象,将其随机分为对照组和研究组,对照组患者的双腔支气管插管采用Macintosh直接喉镜(MDLS)进行,研究组则采用HC可视喉镜联合UE可视软性喉镜。比较两组插管定位所需时间、一次性插管成功率、喉镜下声门显露程度Cormack-Lehane分级,比较两组患者不同时间点的中心静脉压和心率,及术后48 h内并发症发生情况。结果研究组插管定位时间明显短于对照组,差异有统计学意义(t=6.216,P=0.000);一次性插管成功率为100.00%,显著高于对照组的75.86%,差异有统计学意义(χ~2=15.922,P=0.000),研究组声门显露情况明显优于对照组,差异有统计学意义(P<0.05);T2、T3和T4时研究组的MAP和HR均显著低于对照组,差异有统计学意义(P=0.000);术后48 h内研究组并发症发生率为3.45%,显著低于对照组的20.69%,差异有统计学意义(χ~2=8.123,P=0.004)。结论 HC可视喉镜配合UE可视软性喉镜在双腔支气管插管全身麻醉中较普通直视喉镜可显著缩短插管定位时间,大大提高了插管成功率,并降低了咽痛、声音嘶哑等并发症的发生率,避免了因视线不佳而误将导管插入食管中事件的发生,尤其适用于普通直视喉镜下声门显露困难的患者,同时其对患者血流动力学指标影响更小,安全性更高,值得临床推广应用。

Objective To investigate the effect of HC laryngoscope combined with UE on soft laryngoscope in double lumen bronchial intubation. Methods Convenient select a total of 116 patients undergoing thoracic surgery underwent general anesthesia with double-lumen bronchial intubation in the hospital from March 2014 to March 2018 were randomly divided into control group and study group. The bronchial intubation was performed with the Macintosh direct laryngoscope （MDLS）, and the study group was treated with a HC visual laryngoscope combined with a UE visual soft laryngoscope. The time re- quired for intubation positioning, the success rate of one-time intubation, and the degree of glottic exposure under the laryngoscope were compared by Cormack-Lehane classification. The central venous pressure and heart rate at different time points were compared between the two groups, and the complications within 48 hours after operation. Results The intubation time of the study group was significantly shorter than that of the control group,the different was statistically significant （t= 6.216, P=0.000）. The success rate of disposable intubation was 100.00%, which was significantly higher than that of the control group （75.86%）,the different was statistically significant（x2=15.922, P=0.000）. The glottis exposure of the study group was significantly better than that of the control group,the different was statistically significant （P〈0.05）. The MAP and HR of the study group were significantly lower than those of the control group at T2, T3 and T4,the different was statistically significant （P=0.000）; The complication rate was 3.45%, which was significantly lower than 20.69% in the control group,the different was statistically significant （X2=8.123, P=0.004）. Conclusion HC video laryngoscope combined with UE visual soft laryngoscope can significantly shorten the intubation positioning time and improve the intubation success rate and reduce the sore throat. The incidence of complications such as hoarseness and hoarseness avoids the accidental insertion of the catheter into the esophagus due to poor vision, especially for patients with difficulty in revealing the glottis under normal direct laryngoscopy, and its blood flow to the patient. The academic indicators have less impact and higher safety, which is worthy of clinical application.