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| 可视软镜下导引型气管导管在颈椎手术中经口气管插管的效果 |
| Effects of video intubationscope-guided orotracheal intubation with guided endotracheal tube in cervical spine surgery patients |
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| DOI：10.12089/jca.2022.07.006 |
| 中文关键词: 导引型气管导管 加强型气管导管 可视软镜 经口气管插管 颈椎手术 |
| 英文关键词: Guided endotracheal tube Strengthening tracheal tube Video intubationscope Orotracheal intubation Cervical spine surgery |
| 基金项目:亳州市人民医院三新项目（2021YB-48） |
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| 摘要点击次数: 1287 |
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| 中文摘要: |
目的 观察和比较可视软镜下导引型气管导管和加强型气管导管在颈椎手术患者中应用的效果。
方法 选择择期全身麻醉颈椎手术患者86例，男51例，女35例，年龄34～64岁，BMI 19～24 kg/m 2，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为三组：斜面不朝向患者头端组（NTH组，n=28）、斜面朝向患者头端组（TH组，n=29）和导引型气管导管组（GT组，n=29）。NTH组和TH组患者采用加强型气管导管，NTH组导管斜面朝向患者头端，TH组导管斜面不朝向患者头端，GT组患者采用无斜面的导引型气管导管。记录气管插管时间、置管时间、置管次数、插管过程中低氧血症例数和置管难度分级；记录首次置管成功例数和低氧血症发生率；记录术后吞咽困难、咽喉疼痛和声音嘶哑发生情况。
结果 TH组和GT组插管时间、置管时间明显短于NTH组（P<0.05），置管次数明显少于NTH组（P<0.05），首次置管成功率明显高于NTH组（P<0.05），置管难度明显低于NTH组（P<0.05），吞咽困难、咽喉疼痛、声音嘶哑发生率明显低于NTH组（P<0.05）。GT组置管难度明显低于TH组（P<0.05）。三组低氧血症发生率差异无统计学意义。
结论 可视软镜引导下颈椎手术患者经口气管插管，采用气管导管斜面朝向患者头端和导引型气管导管，置管更快速、高效，术后并发症发生率低。使用导引型气管导管置管操作更简单、难度更低。 |
| 英文摘要: |
Objective To investigate the effect of video intubationscope-guided orotracheal intubation with guided endotracheal tube in cervical spine surgery.
Methods Eighty-six patients, 51 males and 35 females, aged 34 - 64 years, BMI 19 - 24 kg/m 2, ASA physical status Ⅱ or Ⅲ, were selected for elective cervical spine surgery under general anesthesia. They were randomly divided into three groups: the bevel of the tracheal tube facing the caudalward direction group (group NTH, n = 28), the bevel of the tracheal tube facing the cephalad direction group(group TH, n = 29), and guided endotracheal tube group (group GT, n = 29). The intubating time, catheterization time, the number of intubation, the number of cases of hypoxia during intubation, and the grade of resistance during intubation were recorded. The success rate of first catheterization, the incidence of hypoxemia, the incidence of dysphagia, sore throat, and hoarseness were recorded.
Results The intubation time and catheterization time of group TH and group GT were significantly shorter than that in group NTH (P < 0.05), the number of intubation were significantly less than that in group NTH (P < 0.05), the success rate of first intubation was significantly higher than that in group NTH (P < 0.05), and the intubation resistance was significantly lower than that in group NTH (P < 0.05). The incidence of dysphagia, sore throat, and hoarseness in group TH and group GT were significantly lower than that in group NTH (P < 0.05). The resistance of group GT was significantly lower than that in group TH (P < 0.05). There was no significant difference in the incidence of hypoxia among the three groups.
Conclusion Patients with cervical vertebrae were intubated through orotracheal tube under video intubationscope, and the endotracheal tube was inclined to the head of the patient and the guided endotracheal tube, which was faster and more efficient, and the incidence of postoperative complications was lower. The operation of intubation with guided endotracheal tube is simpler and the resistance is less. |
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