可视喉镜下手工中立位气管插管对颈髓损伤患者的影响

目的：观察可视喉镜下手工中立位全麻气管插管对颈椎颈髓手术患者术中血流动力学以及术后并发症的影响。方法：选择60例全麻手术患者，随机分为两组，每组30例，即直视喉镜组（对照组），手工中立位可视喉镜组（研究组）。对两组患者分别使用直视喉镜、手工中立位可视喉镜进行气管插管，比较两组患者首次插管成功率、围插管期血流动力学及术后24h咽喉部并发症发生率。结果：与直视喉镜组比较，可视喉镜组首次插管成功率明显提高（P〈0．05）、围插管期血流动力学波动幅度更小（P〈0．05），术后咽喉部并发症发生率降低（P〈0．05）。结论：与直接喉镜相比，手工中立位可视喉镜可以缩短气管插管的用时，改善围插管期血流动力学波动，减轻咽喉部的损伤。

Effects of the Patients with Cervical Spinal Cord Injury undergoing Tracheal Intubation with Cervical Spine Manual-in-line Immobilization

Objective： To investigate the effects of postoperative laryngopharyngeal complications of the patients with cervical spine surgery undergoing tracheal intubation with cervical spine manual-in-line immobilization under videolaryngoscopy. Method： 60 patients requiring general anesthesia were randomly divided into two groups （n = 30 each ）, namely, direct laryngoscopy group （ group A ）, videolaryngoscopy group （group B）. Patients were randomly allocated to intubation with videolaryngoscopy or direct laryngoscopy. The number of intubation attempts, hemodynamic parameters and the incidence of postoperative laryngopharyngeal complications were recorded. Result： Compared with group A, patients airways were successfully managed on the first attempt ingroup B （ P〈0.05 ） , hemodynamic instability were better during intubation （ P〈0. 05 ）, and the incidence of postoperative laryngopharyngeal complications decreased （ P〈0.05 ）. Conclusion： Compared with direct laryngoscopy, cervical spine manual-in-line immobilization under videolaryn- goscopy can improve the speed or ease of intubations and attenuate the laryngopharyngeal injury.