Glide Scope视频喉镜在全麻剖宫产术气管插管中的应用

章文靖; 姚飞; 熊华平; 许少军

doi:10.7619/jcmp.201912005

Glide Scope视频喉镜在全麻剖宫产术气管插管中的应用

南京医科大学附属无锡妇幼保健院麻醉科, 江苏无锡, 214002

详细信息

通讯作者:
许少军, E-mail: wxfy2139@163.com

中图分类号: R614
计量
- 文章访问数: 312
- HTML全文浏览量: 149
- PDF下载量: 3
出版历程
- 收稿日期: 2019-04-14
- 录用日期: 2019-05-19
- 网络出版日期: 2021-02-22
- 发布日期: 2019-06-27

Application of Glide Scope videolaryngoscopein tracheal intubation of patients with cesarean section under general anesthesia

Department of Anesthesiology, Wuxi Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, 214002

摘要

摘要:
目的评价Glide Scope视频喉镜应用于全麻剖宫产手术气管插管的有效性和安全性。
方法择期行全麻剖宫产手术患者30例，随机分为M组与G组，每组15例。M组采用McCoy喉镜行气管插管术, G组采用Glide Scope视频喉镜行气管插管术。记录2组声门暴露分级、一次插管成功例数、插管时间; 记录2组麻醉诱导前(T₁)、插管后即刻(T₂)、插管后1 min(T₃)、插管后5 min(T₄)的心率(HR)和平均动脉压(MAP); 记录2组插管后口咽黏膜损伤、牙齿牙龈损伤、拔管后咽痛和声音嘶哑等不良反应的发生情况。
结果 G组声门暴露分级显著低于M组(P < 0.05), 插管时间显著短于M组(P < 0.05)。2组一次插管成功例数比较，差异无统计学意义(P>0.05)。M组T₂时点的HR、MAP显著高于G组(P < 0.05)。G组的气管插管不良反应发生率显著低于M组(P < 0.05)。
结论 Glide Scope视频喉镜应用于全麻剖宫产手术气管插管具有声门暴露容易、气管插管成功率高、插管时间短、不良反应少等优势。
- Glide Scope视频喉镜 /
- 气管插管 /
- 全身麻醉 /
- 剖宫产 /
- 不良反应
Abstract:
Objective To evaluate the efficiency and safety of Glide Scope videolaryngoscope in tracheal intubation of patients with cesarean section under general anesthesia.
Methods Totally 30 patients with selective cesarean section under general anesthesia were randomly divided into group M and group G, with 15 cases in each group. Group M underwent tracheal intubation by McCoy laryngoscope, and Group G underwent tracheal intubation by Glide Scope videolaryngoscope. The exposure grade of glottis, the number of patients with successful intubation by one time and intubation time were recorded in both groups. The heart rate (HR) and mean arterial pressure (MAP) were recorded at time points of before induction of anesthesia (T₁), immediately after intubation (T₂), 1 minute after intubation (T₃), 5 minutes after intubation (T₄). The complications such as oral and pharyngeal mucosa injury, gum injury, pharyngalgia and hoarseness after extubation were recorded in both groups.
Results The exposure grade of glottis in group G was significantly lower than that in group M (P < 0.05), and the intubation time was significantly shorter than that in group M (P < 0.05). There was no significant difference in the number of patients with successful intubation by one time between the two groups (P>0.05). HR and MAP at T₂ in group M were significantly higher than those in group G (P < 0.05). The incidence of adverse reactions caused by tracheal intubation in group G was significantly lower than that in group M (P < 0.05).
Conclusion Glide Scope videolaryngoscope has the advantages of easy glottic exposure, high success rate of tracheal intubation, short intubation time and less adverse reactions in tracheal intubation of patients with cesarean section under general anesthesia.
- Glide Scope videolaryngoscope /
- tracheal intubation /
- general anesthesia /
- cesarean section /
- adverse reactions

HTML全文

表 1 2组患者声门暴露分级、插管时间和一次插管成功情况比较(x±s)[n(%)]

组别	n	声门暴露分级			插管时间/s	一次插管成功
组别	n	Ⅰ级	Ⅱ级	Ⅲ、Ⅳ级	插管时间/s	一次插管成功
M组	15	7(46.7)	7(46.7)	1(6.7)	46.2±11.3	15(100.0)
G组	15	13(86.7)^*	2(13.3)^*	0	27.4±7.8^*	15(100.0)
与M组比较。*P < 0.05。

下载: 导出CSV

表 2 2组患者各时点血流动力学比较(x±s)

组别	n	T₁		T₂		T₃		T₄
组别	n	HR/(次/min)	MAP/mmHg	HR/(次/min)	MAP/mmHg	HR/(次/min)	MAP/mmHg	HR/(次/min)	MAP/mmHg
M组	15	70.4±12.0	82.0±10.0	75.0±10.0	95.0±12.0	73.0±13.0	81.0±13.0	69.0±11.0	78.0±9.0
G组	15	70.0±14.0	81.0±10.0	84.0±7.0^*	84.0±9.0^*	78.0±12.0	79.0±10.0	75.0±13.0	74.0±12.0
HR: 心率; MAP: 平均动脉压。T₁: 麻醉诱导前; T₂: 插管后即刻; T₃: 插管后1 min; T₄: 插管后5 min。与M组比较, *P < 0.05。

下载: 导出CSV

表 3 2组患者不良反应发生情况比较[n(%)]

组别	n	口腔黏膜损伤	咽喉痛	牙齿牙龈损伤
M组	15	3(20.0)	1(6.7)	0
G组	15	1(6.7)^*	0	0
与M组比较, *P < 0.05。

下载: 导出CSV

参考文献(15)

[1]	邓小强, 高之心, 张雷, 等. Glide Scope视频喉镜在全麻气管插管中的应用[J]. 安徽医药, 2012, 16(2): 190-192. doi: 10.3969/j.issn.1009-6469.2012.02.020
[2]	李锁北, 阮溦, 杨东林, 等. Glide Scope视频喉镜在双腔支气管导管插管中的临床应用[J]. 中国内镜杂志, 2010, 16(5): 492-495. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201005016.htm
[3]	刘俊杰, 赵俊. 现代麻醉学[M]. 2版. 北京: 人民卫生出版社, 1995: 540-546.
[4]	张平, 龚辉, 周丹丹. 瑞芬太尼靶控输注用于剖宫产全麻诱导及维持对产妇及新生儿的影响[J]. 陕西医学杂志, 2017, 46(2): 252-254. doi: 10.3969/j.issn.1000-7377.2017.02.048
[5]	汪涛, 张望平. 琥珀胆碱与罗库溴铵在剖宫产术全麻诱导中的应用比较[J]. 实用药物与临床, 2016, 19(9): 1132-1134. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC201609019.htm
[6]	丁正年. 危重疑难病人的麻醉及并发症的处理[M]. 2版. 南京: 东南大学出版社, 2013: 123-124.
[7]	宋恒佳, 黄东升. 瑞芬太尼用于剖宫产全麻对产妇及新生儿的影响[J]. 海峡药学, 2016, 11(9): 130-132. doi: 10.3969/j.issn.1006-3765.2016.09.058
[8]	KODALI B S, Chandrasekhar s, BULICH L N, et al. Airway changes during labor and delivery[J]. Anesthesiology, 2008, 108(3): 357-362. doi: 10.1097/ALN.0b013e31816452d3
[9]	Sol MS, Gershon L. Anesthesia for obstetrics[M]. 3rd edition. Baltimore: Williams & Wilkins, 1993: 475-481.
[10]	弓胜凯, 张卫. 阻塞性睡眠呼吸暂停综合征患者Glide Scope视频喉镜和Macintosh喉镜气管插管效果比较[J]. 郑州大学学报: 医学版, 2013, 48(3): 398-400. doi: 10.3969/j.issn.1671-6825.2013.03.029
[11]	米勒. 米勒麻醉学[M]. 曾因明, 邓小明译. 北京: 北京大学医学出版社, 2006: 1664-1665.
[12]	Doyle D J, Zuranus A, Ramachandran M. Videolaryngoscopy in the management of the difficult airway[J]. Can J Anaesth, 2004, 51(1): 95-96. doi: 10.1007/BF03018567
[13]	Cuchillo J V, Rodriguez M A. Considerations aimed at facilitating the use of the new GlideScope video laryngoscope[J]. Can J Anaesth, 2005, 52(6): 661-668. doi: 10.1007/BF03015790
[14]	郑雪琴, 梅攀, 罗阳, 等. GlideScope视频喉镜在困难气道患者气管插管术中的临床应用价值和安全性评估[J]. 检验医学与临床, 2016, 13(10): 1307-1309. doi: 10.3969/j.issn.1672-9455.2016.10.004
[15]	林思铭. Glidescope可视喉镜与普通喉镜在急诊危重症气管插管中应用效果比较[J]. 黑龙江医药, 2017, 30(2): 447-449. https://www.cnki.com.cn/Article/CJFDTOTAL-HJYY201702107.htm

施引文献(2)

期刊类型引用(2)

1.	王向阳. PD-1抑制剂联合SOX方案治疗晚期胃癌患者的疗效及对外周血T淋巴细胞亚群水平的影响. 宁夏医学杂志. 2024(06): 461-464 . 百度学术
2.	陈守华，姚卫东，徐美华，肖金章，徐薇薇. PD-1单抗和紫杉醇脂质体联合奈达铂一线治疗进展期食管癌的疗效观察. 中国肿瘤临床与康复. 2022(02): 138-141 . 百度学术