可视喉镜、可视硬性光棒及普通喉镜在鼾症患者气管插管中的应用效果比较

Effect of video laryngoscope,video light wand and traditional laryngoscope application in tracheal intubation in patients with obstructive sleep apnea syndrome

目的:比较可视喉镜、可视硬性光棒和普通喉镜在鼾症患者气管插管中的临床效果。方法:将90例择期手术治疗的鼾症患者随机分为3组,即可视喉镜组(A组)、可视硬性光棒组(B组)及普通喉镜组(R组),每组30例。记录气管插管的次数、插管时间,诱导前(T0)、插管前(T1)、插完管时(T2)及插管后3min(T3)的血压、心率;记录插管时牙龈损伤及口腔黏膜损伤的发生情况。结果:3组T1时刻的心率及血压较T0时刻降低(P<0.05);3组T2、T3时刻的心率及血压高于T1时刻(P<0.05)。在T1时刻,R组血压较B组下降明显(P<0.05)。A组首次插管成功率明显高于R组(P<0.05)。B组、R组插管时间长于A组(P<0.05)。3组口腔黏膜损伤、牙龈损伤发生例数比较,差异均无统计学意义(均P>0.05)。结论:对于鼾症患者,可视喉镜及可视硬性光棒插管成功率较高,而可视喉镜操作更快速简便,是鼾症患者气管插管较好的选择。

Objective: To compare the effect of video laryngoscope,video light wand and traditional laryngoscope application in tracheal intubation in patients with obstructive sleep apnea syndrome (OSAS). Methods: A total of 90 OSAS patients were randomly divide into 3 groups ( n =30 per group): video laryngoscope group (group A),video light wand group (group B) and traditional laryngoscope group (group R).After induction of anesthesia,these three tools were used to perform endotracheal intubation.The success rate of first intubation and tracheal intubation time were recorded.Blood pressure and heart rate were detected at T0 (before induction of anesthesia),T1 (before intubation),T2(immediately after intubation) and T3 (3 min after intubation).Gingival injury and oral mucosal injury during intubation were recorded as well. Results: The heart rate and blood pressure at T1 of all patients were lower than those at T0,while were higher at T2 and T3 than those at T1 ( P <0.05).At T1,the blood pressure in group R was significantly lower than that in group B ( P <0.05).The success rate of the first intubation in group R was significantly higher than that in group R ( P <0.05).The intubation time in group B and group R was longer than that in group A ( P <0.05).There was no significant difference in the number of gingival injury and oral mucosal injury among the 3 groups ( P >0.05). Conclusion: The video laryngoscope and video light wand had high success rate and few complications,and the former was faster and easier to operate that might be a better choice for OSAS in tracheal intubation.