引光器联合呼吸末 CO2在强直性脊柱炎合并插管困难患者中应用的效果分析

目的 评价强直性脊柱炎（AS）合并困难气管插管时用气管插管引光器（引光器）结合呼吸末二氧化碳（PetCO2）经右侧磨牙气管插管的效果及心血管应激反应.方法 选择42例AS合并困难插管拟施全身麻醉患者,入选AS均伴有颈椎侵犯、颈椎前屈后伸受限符合困难插管,随机分为Ⅰ、Ⅱ两组,每组21例,Ⅰ组为引光器插管组,Ⅱ组引光器联合PetCO2插管,两组均用镇静慢诱导方法,咽喉部表麻用气管插管引光器插管引导配合PetCO2经右侧磨牙插管.比较两组插管成功率,插管时间等情况.结果 Ⅰ组一次插管成功率为90.48％,二次插管成功率为9.52％,Ⅱ组一次成功率为95.24％,二次插管成功率为4.76％.插管时间Ⅰ组（45.43±5.23）s,Ⅱ组（40.62±4.75）s,两组插管时间差异有统计学意义（P＜0.05）.两组插管即刻收缩压相比,差异有统计学意义（P＜0.05）.结论 气管插管引光器用于AS困难插管具有良好的插管效果,引光器加PetCO2比单独用引光器更适合于困难插管中,并可缩短插管时间.

Analysis of the effect of light wand endotracheal intubation combining with PetCO2 in difficult airway of patients with ankylosing spondylitis

Objective To evaluate the effect and cardiovascular stress reaction of light wand endotracheal intubation through right molar combining with PetCO2 in difficult airway of patients with ankylosing spondylitis.Methods 42 patients with ankylosing spondylitis accompanied by cervical vertebra invasion and cervical extension and flexion movements limitation with difficult airway who underwent general anesthesia were randomly divided into two groups,group Ⅰ （light wand endotracheal intubation） and group Ⅱ （light wand endotracheal intubation combining with PetCO2）,with 21 cases in each group.Both of two groups were given the sedation in slow induction and light wand endotracheal intubation through right molar combining with PetCO2 under surface anesthesia into the throat.The success rate and time of intubation were compared between the two group.Results The success rate of endotracheal intubation at one time of group Ⅰ was 90.48％ and 95.24％ in group Ⅱ,the success rate of endotracheal intubation at twice of group Ⅰ was 9.52％ and 4.76％ in group Ⅱ.The times of successful intubation in the two groups were （45.43±5.23） s and （40.62±4.75） s respectively,the difference was statistically significant （P ＜ 0.05）.SBP at the moment of endotracheal intubation in the two groups was statistically significant difference （P ＜ 0.05）.Conclusion It shows good result by light wand endotracheal intubation in difficult airway of ankylosing spondylitis patients and using light wand endotracheal intubation combining with PetCO2 is more suitable for difficult airway than using light wand alone,and also can short the time of endotracheal intubation.