【摘要】 目的探讨GlideScope可视喉镜在H7N9禽流感流行期不明原因呼吸道感染患者气管插管中的应用价值。方法对不明原因呼吸道感染需要气管插管呼吸支持的28例患者随机选用Macintosh直接喉镜(M组,18例)和GlideScope可视喉镜(G组,10例)辅助气管插管,记录显露声门、医患鼻口距离(暴露声门即刻操作者鼻尖与患者上切牙之间的距离)、插管次数、患者呛咳次数、气管插管时间和气管插管并发症发生情况,记录患者插管前和插管后即刻的HR、MAP和SpO2,随访操作者1周内发热、咳嗽等呼吸道感染症状。结果与M组相比,G组显露声门时间和气管插管时间短,医患鼻口距离长[(65.8±4.6)cm vs.(32.5±3.7)cm],一次气管插管成功率高(100%vs.66.7%),并发症发生率低(10.0%vs.50.0%)(P<0.05)。两组患者呛咳发生率和插管前后的HR、MAP和SpO2比较差异均无统计学意义(P>0.05)。两组的操作者在气管插管后1周内均未出现发热、咳嗽、咳痰等呼吸道感染症状。结论与采用Macintosh直接喉镜比较,GlideScope可视喉镜辅助气管插管具有损伤小和一次成功率高等优点,并可减少操作者与呼吸道感染患者病原接触机会。更多还原

【Abstract】 Objective To evaluate the clinical application value of GlideScope video laryngoscope in tracheal intubation of the patients with undiagnosed respiratory infections during epidemic period of Avian flu（H7N9）.Methods The tracheal intubation was performed in 28 patients with undiagnosed respiratory infection diseases during epidemic period of H7N9,who needed respiratory support.The intubation was assisted by GlideScope video laryngoscope（group G,10 cases）and Macintosh direct laryngoscope（group M,18 cases）.The time for glottis exposure,the distance between nose tip of operator and upper incisors of the patients immediately after glottis exposure,the number of bucking during intubation and the time spent on intubation were recorded.The heart rate（HR）,mean arterial pressure（MAP）and SpO2 were monitored and during intubation.The operators were followed up for 7 days and respiratory infection symptoms such as fever,cough and expectoration were observed.Results Compared with group M,group G had shorter times for glottis exposure and intubation,longer distance between nose tip of operator and upper incisors of the patients[（65.8±4.6）cm vs.（32.5±3.7）cm],higher success rate of intubation at first attempt（100% vs.66.7%）,and lower incidence of intubation complications（10.0% vs.50.0%）（P<0.05）.There were no significant differences in the incidence of bucking and changes of HR,MAP,SpO₂ during intubation between two groups（P>0.05）.No respiratory infection symptoms appeared in all operators during follow up.Conclusion Compared to Macintosh direct laryngoscope,tracheal intubation assisted by GlideScope video laryngoscope has the advantages of higher success rate of intubation at first attempt and less injury and is able to reduce the risk of pathogen exposure to the operators.更多还原