| 胡丽君,侯百灵,孙玉娥,倪 坤,董媛媛.可视软性喉镜与光棒在颈椎损伤手术患者全身麻醉气管插管中的应用效果比较[J].,2020,(8):1575-1578 |
| 可视软性喉镜与光棒在颈椎损伤手术患者全身麻醉气管插管中的应用效果比较 |
| Comparison of Application Effect of Visual Soft Laryngoscope and Light Stick in General Anesthesia Tracheal Intubation for Patients with Cervical Spine Injury |
| 投稿时间：2019-11-21 修订日期：2019-12-17 |
| DOI：10.13241/j.cnki.pmb.2020.08.039 |
| 中文关键词: 颈椎损伤 可视软性喉镜 光棒 全身麻醉 气管插管 应用效果 |
| 英文关键词: Cervical spine injury Visual soft laryngoscope Light stick General anesthesia Tracheal intubation Application effect |
| 基金项目:江苏省卫生计生委医学科研项目（Q20170476）；2018年度南京市医药卫生科研课题（YKK18071） |
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| 中文摘要: |
| 摘要 目的：比较可视软性喉镜与光棒用于颈椎损伤手术患者全身麻醉气管插管的有效性与安全性。方法：选择2017年1月至2019年2月本院60例高位颈椎骨折需行气管插管全身麻醉的患者，随机分为可视软性喉镜组（U组）和光棒组（G组）各30例。术前所有患者颈托固定，U组使用UE可视软性喉镜行气管插管，G组使用光棒行气管插管，确认气管插管成功后接呼吸机机械通气。比较两组气管插管时间、一次性插管成功率、拔管后口咽部并发症、插管前后的皮层体感诱发电位(CSEP）及运动诱发电位(MMEP)的变化。记录两组患者麻醉前、麻醉诱导后、气管插管后即刻、气管插管后1 min、气管插管后3 min的平均动脉压（MAP）和心率（HR）。结果：U组气管插管时间较G组插管时间长（P<0.05）；U组和G组气管插管一次性成功率分别为95%和100%；插管后即刻G组患者MAP升高较U明显（P<0.05）；与U组比较，G组插管后即刻及插管后1 min、3 min的HR升高较明显（P<0.05）；U组患者口咽部并发症较G组少；两组患者插管后SSEP及MMEP与插管前相比无阳性改变。结论：可视软性喉镜较光棒需要更长的气管插管时间，两者的气管插管一次性成功率均较高，但可视软性喉镜插管期间循环波动较小、术后口咽部并发症较轻，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare effectiveness and safety of general anesthesia endotracheal intubation between visual soft laryngoscope and light stick for patients with cervical spine injury. Methods: From January 2017 to February 2019, 60 patients with high cervical spine fracture who need general anesthesia through tracheal intubation were selected, which were randomly divided into visual soft laryngoscope group (U group) and light stick group (G group) with 30 patients in each group. Before operation, all patients were fixed with neck bracket. U group was intubated with UE visual soft laryngoscope, G group was intubated with light stick. After the intubation was confirmed to be successful, mechanical ventilation was performed with ventilator. The time of tracheal intubation, the success rate of single intubation, oropharyngeal complications after extubation, the changes of cortical somatosensory evoked potential (CSEP) and Myogenic Motor Evoked Potentials (MMEP) before and after intubation were compared between the two groups. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia, after anesthesia induction, immediately after tracheal intubation, 1 min after tracheal intubation and 3 min after tracheal intubation. Results: The intubation time of U group was longer than that of G group (P<0.05), the success rates of single intubation in U group and G group were 95% and 100% respectively. The MAP of G group was significantly higher than that of U group immediately after intubation (P<0.05), the HR of G group immediately after intubation, 1 min and 3 min after intubation was significantly higher than that of U group (P<0.05). The oropharyngeal complications of U group were less than that of G group. There were no positive changes in SSEP and MMEP after intubation compared with those before intubation in the two groups. Conclusion: The intubation time of visual soft laryngoscope is longer than that of light stick, and the success rate of intubation is higher in both cases. However, the circulation fluctuation during intubation of visual soft laryngoscope is less, and the postoperative oropharyngeal complications are less, which is worthy of clinical application. |
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