肥胖患者GlideScope视频喉镜与直接喉镜经口气管插管时血流动力学与声门显露程度的比较

目的观察比较GlideScope视频喉镜和普通喉镜用于肥胖患者经口气管插管的临床效果。方法60例ASAI～Ⅱ级拟择期行经口气管捕管全麻下手术的肥胖患者，随机抽签分成观察组（GlideScope视频喉镜组，n=30）、对照组（直接喉镜组，n=30）。全麻诱导后观察记录诱导前、诱导后、暴露声门时、气管插管时和插管成功后1min的心率和无创血压．同时记录插管时声门暴露程度、捕管时间、一次插管成功率和插管并发症。结果对照组在声门暴露时血压和心率显著高于观察组。观察组Cormark—Lehane分级Ⅲ级以上的病例（1例）明显低于对照组（8例）（p〈0．05）；一次插管成功率为100％，而对照组为93．3％；对照组有2例口唇损伤、3例咽痛，而观察组未发生。结论GlideScope视频喉镜不能减轻插管引起的应激反应，但是可提高声门的暴露程度与插管成功率，减少捅管并发症。

The comparison of the effect of GlideScope video laryngoscope and direct laryngoscope in hemodynamics and exposure of glottis in obese patients during orotracheal intubation

Objective To observe and compare the clinical application of GlideScope video laryngoscope and direct laryngoscope in obese patients orotracheal intubation. Methods Sixty obese patients, ASA physical status from I to II, scheduled for elected operation under general anesthesia requiring orotracheal intubation, were randomly divided into observation group（GlideScope videolaryngoscope,n = 30）and control group （direct laryngoscope,n = 30）. After a standard intravenous anesthesia induction, operated, uoninvasive blood pressures （NBP） and heart rate （HR） were recorded and analyzed before and after anesthetic induction, at glottie exposure, at intubation and lmin after intuba- tion, respectively. Cormark-Lehane grade, orotracheal intubation time, onetime success rate and intubation complica- tions such as pharyngodynia and hoarse voice were also recorded. Results The rise of NBP and HR in control group were significantly higher than those in observation group at glottic exposure. The observation group （above III 1 person） achieved better glottic exposure view than contrastive group （above III 8 persons） （P〈0.05）.The success rate of orotra- cheal intubation on the first attempt was 100% in observation group and 93.3% in control group. There were 2 patients had lips injury, 3 patients had pharyngodynia in control group, while nobody in observation group. Conclusion Compared with direct laryngoscope, the GlideScope video laryngoscope can not reduce the hemodynamic responses, but im- prove glottic exposure view, decrease the difficulty of intubation and less complications obviously, during the orotra- cheal intubation.