GlideScope视频喉镜在颈椎外伤患者气管插管中的应用

目的观察全麻下应用GlideScope视频喉镜进行气管插管的成功率及插管时的心血管反应，评价其在颈椎外伤患者中的应用价值。方法168例择期或急诊颈椎手术患者，美国麻醉医师协会（ASA）分级I-Ⅱ级，随机分为2组（n=84）：Glidescope喉镜组（G组）和纤维支气管镜组（F组）。在快速静脉全麻诱导后分别用GlideScope视频喉镜和纤维支气管镜经口腔插管，记录插管操作时间、次数和并发症，并测量诱导前（T1）、诱导后（T2）、插管时（L）、插管后lmin（T4）、气管插管后3min（T5）的心率（HR）、收缩压（SBP）、舒张压（DBP）及平均动脉压（MAP）。结果G组84例患者中，78例一次插管成功，4例二次插管成功，2例插管失败，改为纤维支气管镜插管，插管成功率为97．6％；F组84例均成功插管。气管插管过程中2组的HR、SBP、DBP、MAP平稳，而且2组间差异无统计学意义（P〉0．05）。结论GlideScope视频喉镜插管迅速，成功率高，心血管反应轻微，操作简便，便于携带，适合颈椎外伤患者应用管理气道。

Application of GlideScope videolaryngoscopy for tracheal intubation in patients with cervical trauma

Objective To valuate the use of GlideSeope videolaryngoscopy in patients with cervical trauma, by observing the success rate of tracheal intubation with GlideScope videolaryngoscopy and cardiovascular response of patients undergoing tracheal intubation after general anesthesia. Methods One hundred and sixty-eight selective or emergency operation patients （ASAI-II） with acute cervical spine injury were randomly divided into 2 groups （ n = 84 ）. GlideScope videolaryngoscopy （ group G） or fibreoptic bronchoscope（ group F） was used in intubate via mouth cavity after intravenous introduced general anesthesia. The procedure time of intubation, the number of intubating and the complication were recorded. Heart rate （HR）, systolic blood pressure （SBP） , diastolic blood pressure （DBP） , mean arterial pressure （MAP） were measured before （T1） and after（T2） anesthesia induction, also measured at the beginning（T3 ） , 1 rain （T4） and 3 rain （T5 ） after tracheal intubation. Results In group G （84 patients）, intubation succeed just once in 78 patients, twice in 4 patients, and 2 other patients were turned to fibreoptic intubation. The success rate was 97.6%. All 84 patients were succeeded to be intubate with fibreoptic bronchoscope in group F. During the intubation, the HR, SBP, DBP, MAP were stable with no statically difference. Conclusion GlideScope videolaryngoscopy introducing intubation seems a useful device in patients with cervical trauma for its high successful rate, rapid intubation, slight cardiovascular response, easily using procedure and convenient carrying.