超声引导下喉上神经阻滞联合ZX-KSHJ可视喉镜在肥胖患者清醒气管插管中的应用效果

Ultrasound-guided superior laryngeal nerve block combined with ZX-KSHJ visual laryngoscope in awake tracheal intubation in obese patients

目的 探讨超声引导下喉上神经阻滞联合ZX-KSHJ可视喉镜在肥胖患者清醒气管插管中的应用效果。方法 选择2018年1月-2020年1月该院收治的120例拟行气管插管全身麻醉的肥胖患者作为研究对象,使用随机数表法将患者分为两组,每组各60例。观察组采用超声引导下喉上神经阻滞联合ZX-KSHJ可视喉镜气管插管,对照组采用超声引导下喉上神经阻滞联合传统光学喉镜气管插管。观察两组患者声门显露成功率、一次性气管插管成功率、总插管成功率、成功插管的平均插管时间、插管过程中呛咳发生率以及呛咳程度、血流动力学和插管相关并发症发生情况。结果 观察组声门显露成功率、一次性气管插管成功率高于对照组(P <0.05),成功插管的平均插管时间短于对照组(P <0.05),插管后1 min (T1)和5 min (T2)患者心率(HR)、无创收缩压(SBP)和无创舒张压(DBP)低于对照组(P <0.05),经皮动脉血氧饱和度(SpO2)高于对照组(P <0.05),口腔出血、咽喉部损伤和气道损伤等并发症总发生率低于对照组(P <0.05)。结论 超声引导下喉上神经阻滞联合ZX-KSHJ可视喉镜气管插管,可提高肥胖患者声门显露成功率和一次性插管成功率,缓解血流动力学波动,减少插管相关并发症发生风险。

Objective To investigate the application effect of ultrasound-guided superior laryngeal nerve block combined with ZX-KSHJ visual laryngoscope on awake tracheal intubation in obese patients.Methods 120 obese patients underwent tracheal intubation general anesthesia from January 2018 to January 2020 were selected as the research objects,and the patients were divided into two groups by random number table method,with 60 cases in each group.The observation group was treated with ultrasound-guided superior laryngeal nerve block combined with ZX-KSHJ visual laryngoscope tracheal intubation,while the control group was treated with ultrasound-guided superior laryngeal nerve block combined with traditional optical laryngoscope tracheal intubation.The success rate of glottic exposure,one-time success rate of tracheal intubation,total success rate of intubation,mean intubation time,incidence and degree of cough during intubation,hemodynamic and intubation-related complications were observed in the two groups.Results The success rate of glottis exposure and one-time success rate of tracheal intubation in the observation group were higher than those in the control group (P < 0.05), the average successfulintubation time were shorter those that in the control group (P < 0.05), heart rate (HR), systolic blood pressure (SBP),and diastolic blood pressure (DBP) at 1 min (T1), 5 min after intubation (T2) were lower than those in the controlgroup (P < 0.05), percutaneous arterial oxygen saturation (SpO2) was higher than that in the control group (P < 0.05),the overall incidence of complications such as oral bleeding, throat damage, airway damage was lower than that in thecontrol group (P < 0.05). Conclusion Ultrasound-guided superior laryngeal nerve block combined with ZX-KSHJvisual laryngoscope tracheal intubation can improve the success rate of glottic exposure and one-time intubation inobese patients, and reduce the risk of hemodynamic fluctuations and intubation related complications.