视频喉镜联合纤维支气管镜在预测困难气道双腔支气管插管中应用.docVIP

视频喉镜联合纤维支气管镜在预测困难气道双腔支气管插管中应用 　　[摘要] 目的 评估HC视频喉镜联合纤维支气管镜在预测困难气道双腔支气管导管（double-lumen tube，DLT）插管中的应用效果。 方法 选择择期DLT插管后行胸科手术的患者80例（ASAⅠ或Ⅱ级，Mallampati Ⅲ或Ⅳ级），随机分为A组（n=40）和B组（n=40）。A组选用HC视频喉镜联合纤维支气管镜引导行双腔支气管插管。B组选用HC视频喉镜下直接行双腔支气管插管。两组插管完成后用纤维支气管镜定位。记录两组声门显露分级、气管插管时间、气管插管一次成功率、咽喉疼痛发生率及血流动力学的变化。 结果 两组在声门显露分级、气管插管时间方面比较差异无统计学意义（P0.05）；A组一次性气管插管成功率较B组高，术后咽喉痛发生率较B组低，差异有统计学意义（P0.05），A组气管插管时的HR、MAP较B组低，差异有统计学意义（P0.05）。 结论 HC视频喉镜联合纤维支气管镜行双腔支气管插管在预测困难气道中可以降低插管难度，减少插管相关并发症。 　　[关键词] 视频喉镜；纤维支气管镜；困难气道；气管插管 　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2016）23-0100-04 　　[Abstract] Objective To evaluate the efficacy of HC videolaryngoscope combined with fiberoptic bronchoscope for double-lumen tube（DLT） intubation in patients with predictable difficult airways. Methods 80 patients（ASAⅠ-Ⅱ， modifide Mallampati grade III-IV ） scheduled for thoracotomy with double-lumen tube intubation were slected and randomly divided them into Group A and Group B， 40 cases in each group. Group A was placed DLT to bronchus by videolaryngoscope and fiberoptic bronchoscope while group B was placed DLT to bronchus directly by HC videolaryngoscope. Both groups used fiberoptic bronchoscope to fix position of DLT. Grades of glottis view， tracheal intubation time， the successful rate of tracheal intubation at first attempt， incidence of throat pain and the hemodynamic changes of both group were recorded. Results There were no statistically significant differences in glottis exposure view and tracheal intubation time between two groups（P0.05）. The first successful rate of tracheal intubation at first attempt was higher and incidence of throat pain was lower in group A（P0.05）. The evaluating level of HR and MAP in group A was significantly lower than that of group B at intubation（P0.05）. Conclusion HC Videolaryngoscope combined with fiberoptic bronchoscope for DLT intubation in patients with predictable difficult airway reduces the difficulty of intubation and the complication of the intubation. 　　[Key words] Vid