【摘要】 目的 评价视频喉镜用于经胸腔镜微创心脏手术食道超声探头置入的效果。方法 选择2017年3月至2019年12月行经胸腔镜微创心脏手术患者40例，年龄39～62岁，体质量45～73 kg, ASAⅡ或Ⅲ级，NYHAⅡ或Ⅲ级，采用随机数字表法分为两组(n=20):视频喉镜组(G组)和对照组(C组)。G组患者在视频喉镜引导下行食道超声(TEE)探头置入，C组采用盲探法。记录TEE探头插入首次成功率及插入次数、插入时间、G组视频喉镜对食道入口的显露情况，口咽黏膜出血及损伤发生率(视频喉镜发现一处及以上损伤则计为损伤)、呼吸道并发症(包括气管插管脱出、错位、异位)的发生情况。结果 与C组比较，G组患者首次插入成功率95%,明显高于C组60%(P<0.05),插入次数明显少于C组(21 vs.30)(P<0.05),插入时间明显短于C组[(28±9)s vs.(51±11)s](P<0.05);G组患者口腔黏膜出血、血肿、损伤发生率及术后拔管1 d咽喉痛发生率明显低于C组(P<0.05)。两组患者呼吸道并发症(包括气管插管脱出、错位、异位)差异无统计学意义(P>0.05)。结论 胸腔镜微创心脏手术中，视频喉镜辅助置入经食管超声探头准确率高、简单易行、并发症少。更多还原

【Abstract】 Objective To evaluate effects of video laryngoscope with thoracoscope esophagus ultrasound probes in minimally invasive cardiac surgery. Methods Clinical data of 40 patients proposed by thoracoscope minimally invasive cardiac surgery were analyzed that patients were 39～62 years old, 45～73 kg of weight, ASA Ⅱ/Ⅲ,NYHA Ⅱ/Ⅲ,and no restriction on gender. By random number table method, patients were divided into video laryngoscope group(group G,n=20) and routine group(group C,n=20). Video laryngoscope guiding ultrasonic(TEE) probes was used in esophagus in group G,and blind test method was used in group C. First success rate of TEE probe insertion, insertion number and time, video laryngoscope exposure of esophagus entrance status, oropharynx mucosal hemorrhage and incidence of injury(one or more injuries found by video laryngoscopy were considered as injury),and respiratory complications(including endotracheal intubation emergence, dislocation and ectopia) were recorded.Results Compared with group C,first insertion success rate in group G was significantly increased(95% vs. 60%, P<0.05),insertion number was decreased significantly(21 vs. 30, P<0.05),and insertion time was significantly shortened[(28±9) s vs.(51±11) s, P<0.05],hemorrhage and hematoma of oral mucosa injury incidence were obviously decreased(P<0.05). Moreover, significant decrease was observed for throat soreness caused by postoperative extubation after 1 day compared with two groups(P<0.05). Furthermore, no significance was found in the respiratory complications between two groups(P>0.05).Conclusion In thoracoscope minimally invasive cardiac surgery, inserting esophagus ultrasonic probe with video laryngoscope showed high accuracy, simple operation and few complications.更多还原