可视喉镜在解剖结构异常的困难气道脑动脉瘤栓塞术患者的应用

目的　评价UE可视喉镜在解剖结构异常的困难气道脑动脉瘤栓塞术患者气管插管的临床应用价值。 方法　20例脑动脉瘤栓塞术的患者， ASAII～III级，Mallampati气道分级Ⅲ～IV级，随机分为UE可视喉镜组（A组）和Macintosh直视喉镜组（B组），每组10例。记录两组患者插管时间，插管成功率，气管插管前(T0)、置入气管导管时min(T1)、置入气管导管后1min（T2）、3min（T3）和5min（T4）的Sp02、HR、SBP及DBP，以及气管插管不良反应的发生情况。 结果　T1、T2和T3时B组的HR、SBP及DBP高于A组，差异有统计学意义（P<0.05）；T4时B组患者HR、SBP及DBP高于A组，差异均无统计学意义（P>0.05）。A组患者插管时间显著低于B组患者，总的不良反应发生率A组显著低于B组。 结论　UE可视喉镜可减轻解剖结构异常的困难气道脑动脉瘤栓塞术患者气管插管时的应激反应，能有效保障患者围麻醉期的安全。

Application of video laryngoscopy in patients an abnormal anatomy in airway who suffer cerebral aneurysm embolization

Objective　 To evaluate application of videolaryngoscopy in patients with an abnormal anatomy in airway who suffer cerebral aneurysm embolization.　Methods　30 patients suffered emergency cerebral aneurysm embolization, ASA II or III, and with Mallampati airway (grade III～IV), were randomly divided into two groups: UE videolaryngoscopy (group A, n=15) and Macintosh direct laryngoscopy (group B, n=15). Tracheal intubation time, success rate of intubation, SpO2, HR, SBP and DBP: before tracheal intubation(T0)，tracheal intubation(T1)，1（T2）、3（T3）and 5（T4） minutes after tracheal intubation were investigated. The adverse reactions were also recorded during tracheal intubation.　Results　HR、SBP、DBP and PaCO2 in group B were higher at T1, T2,T3 than group A (P<0.05). HR,SBP and DBP in group B were higher at T4 than group A (P>0.05). Tracheal intubation time in group B was longer than group A. The ratio of adverse reactions in group A was lower than group B.　Conclusion　UE videolaryngoscopy can reduce stress reactions of tracheal intubation in patients with an abnormal anatomy in airway who suffer cerebral aneurysm embolization, and effectively protect the safety of patients around anesthetic time.