三种气管插管技术在颈椎骨折手术麻醉中的应用的比较

【目的】比较三种插管技术在颈椎骨折手术麻醉中应用的效果。【方法】90例ASAⅠ～Ⅱ级颈椎骨折患者，随机分为3组，分别选用不同的插管技术进行清醒插管。A组用盲探插管新技术；B组用传统盲探技术；C组用纤维光导喉镜引导技术。观察其插管效果及并发症情况。【结果】三组病例在性别、年龄和身高无明显差异（P〉0．05）。三组病人的插管成功率分别为90％（27／30）、73．3％（22／30）、100％（30／30），组间比较有明显差异，B组插管成功率明显低于组A和C组（P〈0．05）；三组病人2次以上操作成功的插管成功率分别为8．57％（5／27）、72．7％（16／22）、13．3％（4／30），B组明显高于其它二组（P〈0．05）；在插管时间上，B组为（11．6±7．7）min，与A组的（4．9±1．7）min和C组的（4．5±1．4）min相比明显延长（P〈0．05）；三组病人插管均未见严重并发症发生。【结论】盲探气管插管新技术提供了一种新型、简便、实用有效、廉价的插管方法，能明显提高颈椎骨折病人气管插管成功率和麻醉安全性。

Comparative Study of Three Intubation Techniques Used In Anesthesia Management For Operation Of Cervical Spine Fracture

Objective] To compare the effects of three intubation techniques used in anesthesia for opera tion of cervical spine fracture. Methods] Ninety cases with cervical spine fracture were randomly divided into 3 groups with 30 for each. They were selected to undergo awake intubation with deferent techniques. Group A received a new blind intubation technique. Group B received traditional blind intubation technique. Group C receive＇d fiberoptic laryngoscope intubation technique. The effects of three intubation techniques and complications of intubation were evaluated. Results] There was no significant deference in sexuality, age and body height among three groups（ P 〉0.05）. The successful rate of intubation in three groups was 90% （27/30）, 73.3 %（22/30） and 100%（30/30）, respectively. Compared to group A and group C, the successful rate of group B was obviously lower（ P 〈0.05）. The rate of more than two attempt to successful intubation in three groups was 18. 57% （5/27）, 72. 7% （16/22） and 13. 3% （4/30）, respectively. Compared to group A and group C , the rate of more than two attempt to successful intubation in group B was obviously higher（ P〈 0.05）. The time of successful intubation in three groups was（4.9±1.7）min, （11.6±7.7）min and （4.5±1. 4）min, respectively. Compared to group A and group C, the time of successful intubation in group B was obviously longer（ P 〈0.05）. There was no significant deference in complications of intubation among three groups （ P 〉0.05） Conclusion] The new blind intuhation technique offers a new, convenient, pragmatic, effective and cheap method of intubation, and can obviously improve successful rate of intubation and anesthesia security for cervical spine fracture cases.