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Discopo?可视管芯在喉部新生物患者全麻插管中的应用
The use of the Discopo? optical laryngoscope for tracheal intubation in patients with neoplasm of larynx
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DOI:
作者:
李卫星,蔡一榕,李文献
LI Weixing, CAI Yirong,LI Wenxian
作者单位:
复旦大学附属眼耳鼻喉科医院麻醉科
Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
关键词:
可视管芯;喉部新生物;气管插管;并发症
Endoscope; Neoplasm,larynx; Tracheal intubation; complication
摘要:
目的 评估一种新型的可视管芯(Discopo®帝视无线内窥镜)在喉部新生物患者全麻插管中的作用。方法 选择2011年1~12月因喉部新生物择期行支撑喉镜手术的患者200例,随机分成Macintosh 喉镜组(M 组)和Discopo®可视管芯组(D组)两组 ,每组100例。全麻诱导后两组患者分别用Macintosh 喉镜或Discopo®可视管芯插入气管导管。观察并记录两种插管方法所需时间和插管次数,插管前和插管时的收缩压(SBP)、舒张压(DBP)、心率( HR),以及与插管相关的损伤发生率。结果 M组插管时间长于D组( P < 0.05),一次插管成功率低于D组;M组插管时的SBP、DBP和HR明显高于插管前,也高于D组插管时的血流动力学参数;D组患者气管插管相关损伤发生率较低( P < 0.05)。结论 与Macintosh 喉镜相比,帝视无线内窥镜气管插管的耗时较少,一次插管成功率较高,插管过程中血流动力学更稳定,插管相关损伤较少。
Objective To observe the application effectiveness of a new Visual Stylet (Discopo®) for tracheal intubation in patients with neoplasm of larynx undergoing suspension laryngoscopy . Methods From January 2011 to December,two hundred patients scheduled for suspension micro laryngoscopic surgery were randomly allocated to one of the two groups (Macintosh direct laryngoscopy group and Discopo group). After intravenous induction, the patients in each group were orally intubated with Macintosh direct laryngoscopy or Discopo. Measurements included intubation time, success rate of first intubation attempt, number of intubation attempts. The systolic and diastolic blood pressure (SBP and DBP), and the heart rate (HR) were recorded just before and at the insertion of tracheal intubation. The incidences of complications during tracheal intubation were also recorded. Results Time of tracheal intubation in the Macintosh laryngoscopy group (26.9±8.0 sec) was longer than that of the Discopo group (21.3±4.5sec), and the success rate of the first attempt in Discopo group (97%) was significantly greater than with the Macintosh laryngoscopy group (83%). Following tracheal intubation in the Macintosh laryngoscopy group, SBP, DBP and HR increased significantly compared with the values before intubation(P<0.05). The SBP, DBP and HR at intubation was also significantly greater in the Macintosh laryngoscopy group than in the Discopo group (P<0.05).The incidences of complications during tracheal intubation were higher in the Macintosh laryngoscopy group than in the Discopo group (P<0.05). Conclusion Compared with Macintosh laryngoscopy, Discopo® optical laryngoscope provided shorter time of tracheal intubation ,increased the first time intubation probability of success and attenuated the hemodynamic responses to intubation in patient with neoplasm of larynx.
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