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帝视内窥镜、普通喉镜、光棒在Debakey I型主动脉夹层患者气管插管操作中的的应用比较
作者:王喆妍 骆璇 吴瑶  
单位:南京市鼓楼医院麻醉科
关键词:帝视内窥镜 主动脉夹层 开胸手术 
分类号:
出版年·卷·期(页码):2014·42·第十期(1130-1133)
摘要:

[摘要]目的:探讨帝视内窥镜、普通喉镜和光棒三种气管插管方法在Debakey I型主动脉夹层患者中的应用效果。方法:60例Debakey I型主动脉夹层行开胸手术治疗患者,随机均分成A组(帝视内窥镜)、B组(普通喉镜)、C组(光棒)。记录诱导前基础值(T1)、插管前(T2)、插管成功时(T3)、插管成功后1min(T4)和5min(T5)的平均动脉压(MAP)、心率(HR)。记录插管一次成功率、插管操作时间。结果:60例患者气管插管全部成功,但B组患者插管的一次成功率显著低于A组和C组,差异有统计学意义(P<0.05);C组气管插管的平均操作时间显著长于A组和B组,差异有统计学意义(P<0.05);T3、T4、T5时B组的MAP、HR显著高于A组和C组,差异有统计学意义(P<0.05);在A组和C组,与T1比较,T2、T3、T4、T5时刻的MAP、HR均有显著降低,差异有统计学意义(P<0.05),而在B组,与T1比较,仅T2时刻的MAP、HR均有显著降低,差异有统计学意义(P<0.05)。结论:与普通喉镜和光棒相比,帝视内窥镜气管插管具有满意的成功率,能缩短气管插管时间,对血流动力学影响小,将其应用于Debakey I型主动脉夹层患者这类高危患者是安全而有益的。

[Abstract] Objective: To explore the application effect of Disposcope, ordinary laryngoscope or tracheal intubation wand for endotracheal intubation in patients with Debakey type I aortic dissection. Methods: 60 patients of Debakey type I aortic dissection were randomly divided into group A (Disposcope), group B(ordinary laryngoscope) and group C (tracheal intubation wand). The MAP and HR were recorded at the time of basic value(T1),before anesthesia intubation (T2),the end of intubation (T3),1 min after intubation(T4) and 5 min after intubation(T5) respectively.Success rate of intubation by one time and the time spent on intubation were recorded. Results:All 60 patients were successfully intubated. The success rate by one time of the patients in group B significantly lower than that of group A and group C(P<0.05); the average operation time of the patients in group C was significantly longer than group A and group B (P<0.05); In the times of T3,T4 and T5 the MAP and the HR in the patients of group B were significantly higher in group A and group C (P<0.05); In group A and group C, compared with T1, the MAP and the HR in the time of T2, T3, T4 and T5 were significantly reduced (P<0.05), while in group B, compared with T1, the MAP and the HR in the time of T2 were significantly lower (P<0.05). Conclusion: Compared with ordinary laryngoscope and tracheal intubation wand, Disposcope has satisfactory success rate of intubation,intubation time and small impact on hemodynamics. Disposcope is safe and useful for the patients with Debakey type I aortic dissection.

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