两种喉镜在48例困难气管插管的比较分析

目的探讨Macintosh直接喉镜与HC可视喉镜在患者困难气管插管的声门暴露评级及血压、心率情况。方法 48例择期手术病人经术前评估确定为困难气道的病人,常规快速诱导,先用直接喉镜显露声门,给予评级,记录SBP、HR,然后改用HC可视喉镜,暴露声门,给予评级,记录SBP、HR然后插管,所有操作均由同一人进行,术前评级采用改良的Mallampati分级,喉镜显露分级采用Cormack和Lehane分级,每级对应相应分数,采用均值±标准差（x±s）表示,行t检验,进行统计学处理,P〈0.05差异有统计学意义。结果 HC可视喉镜组评分明显低于直接喉镜组,收缩压、心律MC组明显高于HC组,两者差异有统计学意义。结论 HC可视喉镜可明显降低困难气道声门暴露分级,提高气管插管成功率,减少气管插管的应激反应。

Comparison anglysis of the Applications of Two Kinds of Laryngoscope in 48 Cases of Difficult Tracheal Intubation

Objective To investigate glottis exposure classifications, blood pressures and heart rates in the applications of Macin- tosh direct laryngoscope and HC video laryngoscope in patients of difficult tracheal intubation. Methods Conventional rapid induc- tion of anesthesia was given to 48 patients, who underwent selective operation and were preoperatively identified with difficulty for traditional tracheal intubation. First by Macintosh direct laryngendoscope and then by HC video laryngoscope, glottises of the pa- tients were exposed and the exposure of glottis was evaluated, SBP and HR of the patients were recorded. Then orotracheal intu- bation was given to all the patients. All the above operations were operated by the same person. Improved Mallampati grade was adopted preoperatively; laryngoscopy grade was evaluated by Cormack and Lehane classification＂-2~. The scores of every grade were calculated by mean ＋ standard deviation, t test and were analyzed statistically, and the differences were statistically significant （P〈 0.05）. Results The scores of Cormack-Lehane （C-L） grade of all patients with HC video laryngoscope were significantly lower than those with Macintosh direct laryngoscope. SBP and HR of the patients with Macintosh direct laryngoscope were significantly higher than those with HC video laryngoscope. Conclusion Orotracheal intubation with HC video laryngoscope can obviously reduce glot- tis exposure classification, increase the success rate of orotracheal intubation and decrease stress reactions.