老年患者全身麻醉中3种不同气管插管工具的应用效果比较

Comparison of the Application Effects of Three Different Endotracheal Intubation Tools in General Anesthesia for Elderly Patients

目的:比较Lightwand光棒、UE可视喉镜和直接喉镜在老年患者全身麻醉气管内插管中的应用效果。方法:择期行全身麻醉的老年患者90例,随机分为3组,Lightwand光棒组(LW组)、UE可视喉镜组(UE组)和直接喉镜组(DLS组),记录并比较插管前1 min(T1)、插管时(T2)、插管后1 min (T3)各时间点3组患者平均动脉压(MAP)、心率(HR)变化及插管用时、插管成功率及插管后不良反应发生情况。结果:3组患者T1时间点血流动力学差异无统计学意义(P>0.05),DLS组T2、T3时间点MAP、HR明显高于LW组和UE组(P<0.05),LW组和UE组T2、T3时间点MAP、HR变化差异无统计学意义(P>0.05)。LW组、UE组插管用时明显短于DLS组(P<0.05),LW组与UE组插管用时差异无统计学意义(P>0.05)。LW组和UE组插管成功率明显高于DLS组(P<0.05)。DLS组不良反应发生率明显高于LW组和UE组(P<0.05),LW组和UE组不良反应发生率差异无统计学意义(P>0.05)。结论:在老年患者全身麻醉气管插管中应用Lightwand光棒、UE可视喉镜,血流动力学波动小,插管用时短、插管成功率高、插管并发症少,值得在老年患者全身麻醉中推广应用。

Objective:To compare the application effect of Lightwand light bar,UE visual laryngoscopeand direct laryngoscope in endotracheal intubation of old age patients under general anesthesia.Methods:90 elderly patients undergoing selective general anesthesia were randomly divided into three groups:Lightwand light bar group(LW group),UE visual laryngoscope group(UE group)and direct laryngoscope group(DLS group).The changes of mean arterial pressure(MAP)and heart rate(HR)at each time point 1 min before intubation(T1),during intubation(T2),and at 1 min after intubation(T3),and the intubation time,success rate and adverse reactions after intubation were recorded and compared among the three groups.Results:There was no statistically significant difference in hemodynamics at the time point of T1(P>0.05).MAP and HR at the time point of T2 and T3 in DLS group were significantly higher than those in LW group and UE group(P<0.05).MAP and HR at the time point of T2 and T3 in LW group and UE group had no statistically significant difference(P>0.05).The average intubation time of LW group and UE group was significantly shorter than that of DLS group(P<0.05).There was no statistically significant difference between LW group and UE group in the average intubation time(P>0.05).The success rate of intubation in LW group and UE group were significantly higher than that in DLS group(P<0.05).The incidence of adverse reactions in DLS group was significantly higher than that in LW group and UE group(P<0.05).There was no statistically significant difference between LW group and UE group in adverse reactions(P>0.05).Conclusion:Lightwand and UE laryngoscope have the advantages of small hemodynamic fluctuation,short intubation time,high intubation success rate and less intubation complications,which are worth popularizing in general anesthesia for elderly patients.