气道打开体位自动调节器在非紧急气管插管中的临床应用研究

Clinical application of a new airway opening device with automatic position adjustment in non-emergency endotracheal intubation

目的:探索气道打开体位自动调节器在非紧急气管插管中的临床应用效果。方法:选取2022年6月至2023年4月在重庆医科大学附属第一医院手术室行择期全麻手术的非紧急气管插管患者312例,并按随机对照原则将患者分为人工对照组和仪器试验组(体位夹角90°组、体位夹角95°组和体位夹角100°组)。比较4组间首次插管成功率、声门视野暴露情况、暴露声门时间、插管时间、尝试插管次数、插管困难量表评分(intubation difficulty scales,IDS评分)以及插管并发症和不良反应发生率的差异。结果:仪器体位夹角100°组的首次插管成功率、声门视野暴露分级(cormack-lehane grade,CL分级)、声门开口百分比评分(the percentage of glottic opening score,POGO评分)、尝试插管次数、暴露声门时间和插管时间均明显优于人工对照组(校正后P<0.05);仪器体位夹角90°组和95°组与人工对照组之间、3组仪器试验组之间的差异无统计学意义(校正后P>0.05);仪器体位夹角95°组和100°组的IDS评分显著低于人工对照组(校正后P<0.05),其他组两两之间的差异无统计学意义(校正后P>0.05);4组在插管并发症的发生率上没有明显差异(P>0.05)。结论:气道打开体位自动调节器在体位夹角90°~100°时均能代替人工方法安全有效地打开非紧急气管插管患者的气道,在体位夹角为100°时能够提高首次插管成功率、改善声门视野暴露、减少尝试插管次数并缩短暴露声门时间和插管时间,在体位夹角95°和100°时能够降低气管插管的困难程度。

Objective:To investigate the clinical application effect of a new airway opening device with automatic position adjustment in non-emergency endotracheal intubation.Methods:A total of 312 patients who underwent non-emergency endotracheal intubation for elective surgery under general anesthesia in the operating room of The First Affiliated Hospital of Chongqing Medical University from June 2022 to April 2023 were enrolled,and they were randomly divided into control group and instrument test group,which was further divided into position angle(PA)90°group,PA 95°group,and PA 100°group.The four groups were compared in terms of the success rate of first intubation,Cormack-Lehane(CL)grade,time of glottis exposure,intubation time,the number of intubation attempts,Intubation Difficulty Scale(IDS)score,and the incidence rates of intubation complications and device-related adverse reac⁃tions.Results:Compared with the control group,the PA 100°group had significantly better success rate of first intubation,CL grade,Percentage of Glottic Opening score,number of intubation attempts,time of glottis exposure,and intubation time(Pafter adjustment<0.05).There were no significant differences in these indices between the PA 90°and 95°groups and the control group,as well as between the three instrument test groups(Pafter adjustment>0.05).The PA 95°group and the PA 100°had a significantly lower IDS score than the control group(Pafter adjustment<0.05),and there was no significant difference between any two of the other groups(Pafter adjustment>0.05).There was no significant difference in the incidence rate of intubation compli⁃cations between the four groups(P>0.05).Conclusion:The new air⁃way opening device with automatic position adjustment can safely and effectively replace the manual method to open the airway of patients undergoing non-emergency endotracheal intubation,and a PA of 100°can increase the success rate of first intubation,improve glottis exposure,reduce the number of intubation attempts,and shorten the time of glottis exposure and intubation time.The difficulty of endotracheal intubation can be reduced at a PA of 95°or 100°.