HC视频喉镜联合纤维支气管镜在颈椎制动患者气管插管中的应用

发布时间：2018-05-28 16:57

本文选题：HC视频喉镜 + 纤维支气管镜　；参考：《中国内镜杂志》2017年03期

【摘要】：目的探讨HC视频喉镜联合纤维支气管镜在颈椎制动患者气管插管中应用。方法选择颈椎制动拟全麻手术患者80例随机分为纤维支气管镜组(F组),HC视频喉镜复合纤维支气管镜经鼻插管组(H组),每组40例。充分局部麻醉及静脉麻醉后,保留自主呼吸,行气管插管。记录诱导前(T_0)、气管插管前即刻(T_1)、气管插管后即刻(T_2)、气管插管后1 min(T3)平均动脉压(MAP)、心率(HR)变化,记录首次插管成功率、插管时间。记录气管插管操作相关并发症发生率。结果两组患者气管插管前即刻(T_1)MAP和HR差异无统计学意义(t=0.75、-0.51,P=0.453、P=0.611);两组插管后即刻(T_2)MAP和HR较气管插管前即刻(T_1)MAP(t=5.08、4.36,P=0.021、P=0.013)和HR(t=7.22、6.54,P=0.026、P=0.031)差异均有统计学意义(P0.05),血流动力学均维持在正常范围,两组间比较MAP和HR差异均无统计学意义(t=-0.51、-0.31,P=0.411、P=0.518);插管后1 min(T3)两组间比较MAP和HR差异均无统计学意义(t=0.38、0.26,P=0.681、P=0.372)。H组患者首次气管插管成功率明显高于F组,差异有统计学意义(χ2=7.31,P=0.007)。两组气管插管时间H组明显少于F组,差异有统计学意义(t=5.75,P=0.000)。F组患者术后咽痛发生率明显高于H组,差异有统计学意义(χ2=5.00,P=0.025)。结论颈椎制动患者经鼻气管插管中,HC可视喉镜联合纤维支气管镜,较传统纤维支气管镜插管,首次插管成功率更高,插管时间更短,不加重血流动力学波动,咽痛发生率更低。
[Abstract]:Objective to investigate the application of HC video laryngoscope and fiberoptic bronchoscope in tracheal intubation in patients with cervical spine immobilization. Methods Eighty patients undergoing general anesthesia for cervical spine immobilization were randomly divided into fiberoptic bronchoscope group (n = 40) and fiberoptic bronchoscope group (n = 40). After full local anesthesia and intravenous anesthesia, maintain spontaneous breathing and intubate tracheal intubation. The changes of mean arterial pressure (MAPP) and heart rate (HRR) were recorded before induction, immediately before tracheal intubation, immediately after tracheal intubation, 1 min after tracheal intubation, and 1 min after tracheal intubation. The success rate of first intubation and the time of intubation were recorded. The incidence of complications associated with tracheal intubation was recorded. Results there was no significant difference in map and HR between the two groups immediately before tracheal intubation. There were significant differences between the two groups in terms of T2MAP and HR immediately after intubation (P 0.031) and HRT 7.226.54P0.026P0.031), and the hemodynamics was maintained in the normal range (P 0.031), and the difference was not significant between the two groups before trachea intubation (P < 0.05), but there was no significant difference between the two groups before tracheal intubation (P < 0.05), and the difference between the two groups was significant (P 0.05), and the hemodynamics of the two groups was maintained in the normal range (P 0.05), and the difference between the two groups before tracheal intubation was significant (P < 0.05). There was no significant difference in MAP and HR between the two groups. There was no significant difference in MAP and HR between the two groups (P < 0. 51- 0. 31, P 0. 411, P 0. 518). There was no significant difference in MAP and HR between the two groups. The success rate of first tracheal intubation in group H was significantly higher than that in group F (蠂 2, 7. 31, P 0. 007, P 0. 007). The tracheal intubation time in group H was significantly less than that in group F, and the difference was statistically significant. The incidence of postoperative pharyngias in group F was significantly higher than that in group H (蠂 2 5.00). Conclusion HC visual laryngoscope combined with fiberoptic bronchoscope is more successful than traditional fiberoptic bronchoscopy in the transnasal tracheal intubation in patients with cervical spine immobilization. The first intubation success rate is higher, the intubation time is shorter, hemodynamic fluctuation is not aggravated, and the incidence of pharynx is lower.
【作者单位】：浙江省湖州市中心医院麻醉科;
【分类号】：R614.2

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