【摘要】 目的比较帝视内镜(Disposcope镜)与纤维支气管镜用于模拟颈椎制动患者气管插管的效果。方法选择行全身麻醉、美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级的患者60例,男26例,女34例,年龄18~60岁。采用随机数字表法将患者分入帝视内镜辅助气管插管组(帝视内镜组)和纤维支气管镜辅助气管插管组(纤维支气管镜组),每组30例。所有患者均于麻醉诱导前佩戴颈托模拟颈椎制动,常规行麻醉诱导后,分别于麻醉诱导前、气管插管前、气管插管后即刻各时间,记录患者的收缩压(SBP)、舒张压(DBP)和心率(HR),同时记录两组患者声门暴露时间、声门暴露至插管成功的时间、插管时间<1min的患者构成比、1次插管成功率和插管总成功率。结果帝视内镜组有1例患者因声门显露困难,在2次气管插管失败后改为纤维支气管镜辅助气管插管1次成功。帝视内镜组声门暴露至插管成功的时间显著短于纤维支气管组(P<0.05),两组间声门暴露时间、插管时间<1min的患者构成比、1次插管成功率和插管总成功率的差异均无统计学意义(P值均>0.05)。帝视内镜组气管插管前和气管插管后即刻的SBP、DBP,以及气管插管前的HR均显著低于同组麻醉诱导前(P值均<0.05);气管插管后即刻的HR显著高于同组气管插管前(P<0.05)。纤维支气管镜组气管插管前的SBP、DBP和HR均显著低于同组麻醉诱导前(P值均<0.05),气管插管后即刻的HR显著高于同组麻醉诱导前(P<0.05),气管插管后即刻的SBP、DBP和HR均显著高于同组气管插管前和帝视内镜组同时间(P值均<0.05)。结论帝视内镜可安全有效地用于模拟颈椎制动患者的气管插管,并能缩短插管时间和减轻插管反应。更多还原

【Abstract】 Objective To compare the efficacies of endotracheal intubation with Disposcope versus fiberoptic bronchoscope in patients undergoing cervical spine immobilisation by semirigid neck collar.Methods Sixty American Society of anesthesiologists(ASA)physical statusⅠorⅡadult patients requiring general anesthesia were enrolled in this study.There were 26 males and 34 females aged from 18 to 60years old.They were randomly divided into two groups(n=30).Disposcope and fiberoptic bronchscope were intubated in Disposcope group and fiberoptic bronchscope group,respectively.All patients wore a neck collar before anesthesia induction.Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were recorded before induction,before intubation and after intubation.The glottis exposure time,the time from glottis exposure to successful intubation,one-time success cases of intubation,the cases of intubation time less than one minute and successful intubation cases were also recorded.Results In Disposcope group,one-time successful intubation with fiberoptic bronchoscope was achieved in one patient after difficult glottis exposure and twice failed intubation with Disposcope.The time from glottis exposure to successful intubation in Disposcope group was significantly shorter than that in fiberoptic bronchoscope group(P<0.05).There were no significant differences in terms of the time of glottis exposure,patient proportion of successful intubation time less than one minute,one-time success rate of intubation,or total success rate of intubation between two groups(all P>0.05).In Disposcope group,SBP and DBP before and after intubation,and HR before intubation were significantly decreased as compared with the parameters before anesthesia induction,HR after intubation was significantly higher than that before intubation(all P< 0.05).In fiberoptic bronchoscope group,compared with the parameters before anesthesia induction,SBP,DBP and HR before intubation were significantly decreased,while HR after intubation was significantly increased(all P< 0.05).SBP,DBP and HR after intubation in fiberoptic bronchoscope group were significantly higher than those before intubation in fiberoptic bronchoscope group and those in Disposcope group at the same time(all P< 0.05).Conclusion Disposcope is safe and effective in cervical spine immobilization.It can significantly shorten time of intubation and decrease stress reaction of intubation.更多还原