Airtraq可视喉镜在困难气道全麻患者气管插管中的应用

目的观察应用Airtraq可视喉镜对困难气道患者全麻中行气管插管的临床效果。方法选择拟经口气管插管全身麻醉下实施择期手术的困难气道患者60例,MallampatisⅢ～Ⅳ级,随机分为Airtraq组、Macintosh组,每组各30例。两组均采用慢诱导气管插管,诱导后分别采用Airtraq可视喉镜及Macintosh喉镜进行气管插管操作,比较两组气管插管一次成功率、插管时间和麻醉诱导前（T1）、诱导后（T2）、气管插管后即刻（T3）及气管插管后3 min（T4）的HR、SBP、DBP,观察两组声门暴露及并发症情况。结果 Airtraq组气管插管一次成功率高于Macintosh组,插管时间短于Macintosh组,T3、T4时HR、SBP、DBP低于Macintosh组,并发症发生率低于Macintosh组（P均〈0.05）。Airtraq组Ⅰ级气管插管声门暴露的比例高于Macintosh组（P〈0.05）。结论 Airtraq可视喉镜具有快速、声门暴露好、气管插管时血流动力学变化幅度小、插管损伤小的优点,适合于困难气道患者的气管插管。

Application of Aitraq laryngoscopy in general anesthesia patients with difficult tracheal intubation

Objective To observe the clinical effects of the Airtraq laryngoscope in patients of general anesthesia with difficult tracheal intubation. Methods Sixty Mallampatis Ⅲ to Ⅳ patients with difficult tracheal intubation scheduled for elective operation under general anesthesia were randomized allocated into two groups（ n = 30 for each）,which was the Airtraq group and the Macintosh group. Both of the two groups were adopted slow induction. Patients in each group were orally intubated with Airtraq laryngoscope or Macintosh laryngoscopy,respectively. The success rate of the first time,intubation time,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,heart rate（ HR） before anesthesia induction（ T1）,after anesthesia induction（ T2）,during intubation（ T3） and 3 minutes after intubation（ T4） of the two groups were compared. The glottic exposure view and postoperative complications of the two groups were observed. Results The firsttime successful intubation rate of Airtraq group was higher than Macintosh group（ P〈0. 05）. Intubation time of Airtraq group was significantly shorter than Macintosh group（ P〈0. 05）. Compared with Macintosh group,SBP,DBP and HR at T3 and T4of Airtraq group were lower（ P〈0. 05）. Airtraq group had lower rate of postoperative complications than Macintosh group（ P〈0. 05）. The laryngeal exposure rate of grade I in Airtraq group was higher than that in Macintosh group.Conclusions Airtraq laryngoscopy could effective solve the difficult tracheal intubation quickly,achieve better glottic exposure view,with less hemodynamic effects and less intubation injuries on human body. Airtraq laryngoscopy was suitable for patients with difficult tracheal intubation.