维迪欧视频喉镜在神经监护气管插管定位的应用研究

目的:评估维迪欧视频喉镜在甲状腺肿瘤手术全麻神经监护气管插管定位中的有效性和安全性。方法: 120例择期行甲状腺肿瘤手术且需要神经监测的患者随机分为三组:A组：维迪欧视频喉镜组，B组：GlideScope喉镜组和C组：Macintosh喉镜组。分别记录各组插管前后血流动力学变化、声门暴露时间、神经监护气管插管时间、一次插管成功数、一次导管定位成功数，插管并发症等。结果:行神经监护气管插管时, A组心率及平均动脉压较B组有显著升高（P＜0.05），声门显露时间A组（9.5±3.2s）显著短于C 组(12.8±3.6s)，与B组(9.1±3.5s)无差异，插管时间A组（49.5±17.8s）及C组（51.8±13.1s）均显著长于B组（38.8±10.9s）。A组和B组插管1次成功例数高于C组，且一次导管定位成功例数显著高于C组。结论:神经监护气管插管时，维迪欧视频喉镜优于Macintosh喉镜，但血流动力学变化比GlideScope喉镜明显，时间比GlideScope喉镜稍长，但一次插管成功率无差异。因此，维迪欧视频喉镜在甲状腺肿瘤患者神经监护气管插管中是安全有效的。

Application of VDOSCOPE in electrophysiologic monitoring tracheal intubation

Objective: To evaluate the efficacy and safety of VDOSCOPE in neuromonitoring tracheal intubation for patients with thyroid tumors under general anesthesia. Methods: 120 patients scheduled for thyroid cancer surgery and requiring nerve monitoring were randomly divided into three groups: group A: VDOSCOPE group, group B: GlideScope group and group C: Macintosh group. The glottic exposure time, neuromonitoring tracheal intubation time, successful number of primary intubation, successful number of primary catheter positioning, complications of intubation were recorded. Results: There were significant differences in heart rate and mean arterial pressure during intubation in Group A and Group B (P<0.05). The time of glottic exposure in group A (9.5±3.2s) and group B (9.1±3.5s) was significantly shorter than that in group C (12.8±3.6s), the intubation time of group A (49.5±17.8s) and group C (51.8±13.1s) was significantly longer than that of group B (38.8 +10.9s). The number of successful intubation in group A and B was higher than that in group C. The number of successful primary catheterization was significantly higher than that in group. C.Conclusions: VDOSCOPE is superior to Macintosh laryngoscope in neuromonitoring endotracheal intubation, but hemodynamic changes during intubation are more obvious than GlideScope laryngoscope. VDOSCOPE intubation time is slightly longer than GlideScope laryngoscope, but there is no difference in the success rate of one intubation.Therefore, VDOSCOPE is safe and effective in general anesthesia induction and neuromonitoring tracheal intubation in patients with thyroid tumors.