可视喉镜引导下辅助床旁支气管镜定位在肺尘埃沉着病患者全肺灌洗术中的应用效果

Application effect of assisted bedside bronchoscopy guided by visual laryngoscope in whole lung lavage in patients with pneumoconiosis

目的探讨可视喉镜引导下辅助床旁支气管镜定位在肺尘埃沉着病患者全肺灌洗术中的应用效果。方法选取2021年7月至2022年12月赣州市第五人民医院收治的100例肺尘埃沉着病患者作为研究对象,根据插管方式的不同将其分为I组、P组(各50例),I组采用普通喉镜插管,P组采用可视喉镜引导下辅助床旁支气管镜定位,比较两组患者的一次性插管成功率、插管部位符合率、插管时间、声门显露分级、血流动力学参数变化、并发症总发生率。结果P组患者的一次性插管成功率(100.00%)、插管部位符合率(98.00%)均高于I组(88.00%、84.00%),差异有统计学意义(P<0.05)。P组患者的插管时间短于I组,差异有统计学意义(P<0.05)。P组的声门显露分级优于I组,差异有统计学意义(P<0.05)。P组患者的诱导前(T_(0))、诱导后(T_(1))平均动脉压(MAP)、心率(HR)与I组比较,差异无统计学意义(P>0.05);P组患者的插管即刻(T_(2))、插管5 min后(T_(3))MAP、HR均低于I组,差异有统计学意义(P<0.05)。P组患者的并发症总发生率(2.00%)低于I组(16.00%),差异有统计学意义(P<0.05)。结论可视喉镜引导下辅助床旁支气管镜定位可提高肺尘埃沉着病患者全肺灌洗术一次性插管成功率、插管部位符合率,缩短插管时间,改善声门暴露程度,维持心率、血压等生命体征稳定,降低咽喉受损等并发症发生率,提高插管安全性。

Objective To explore the application effect of assisted bedside bronchoscopy guided by visual laryngoscope in whole lung lavage for pneumoconiosis patients.Methods A total of 100 patients with pneumoconiosis from the Fifth People's Hospital of Ganzhou from July 2021 to December 2022 were selected as research objects,and divided into group I and group P(with 50 cases in each group)according to the difference ways of intubation.Group I was intubated by general laryngoscope,group P was located by bronchoscope under visual laryngoscope guidance.The success rate of one-off intubation,site compliance,intubation time,glottis exposure grade,changes in hemodynamics parameters,and total complication rate were compared between the two groups.Results The success rate of one-time intubation(100.00%)and the coincidence rate of intubation site(98.00%)in group P were higher than those in group I(88.00%,84.00%),the differences were statistically significant(P<0.05).The intubation time in group P was shorter than that in group I,the difference was statistically significant(P<0.05).The glottis exposure grade of group P was better than that of group I,the difference was statistically significant(P<0.05).There were no statistically significant differences in the mean arterial pressure(MAP)and heart rate(HR)before induction(T_(0))and after induction(T_(1))between group P and group I patients(P>0.05).The MAP and HR of patients in group P immediately(T_(2))and 5 min after intubation(T_(3))were lower than those in group I,the differences were statistically significant(P<0.05).The total incidence of complications in group P(2.00%)was lower than that in Group I(16.00%),the difference was statistically significant(P<0.05).Conclusion Under the guidance of visual laryngoscope,the position of bronchoscope beside can improve the success rate of one-time intubation,the coincidence rate of intubation site,shorten the intubation time and improve the exposure of glottis in patients with pneumoconiosis lung lavage,maintain the stability of heart rate,blood pressure and other vital signs,reduce the incidence of complications such as throat injury,improve the safety of intubation.