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两种视频喉镜在悬雍垂腭咽成形术全身麻醉中的应用

王桂平1,常立华2,张鹏3,王久健1,白广2   

  1. 1. 天津市大港油田总医院手术麻醉科
    2. 天津市大港油田总医院麻醉科
    3. 天津大港油田总医院麻醉科
  • 收稿日期:2013-12-05 修回日期:2014-03-31 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 王桂平

Application of two kinds of video laryngoscope in general anesthesia during UPPP operation

  • Received:2013-12-05 Revised:2014-03-31 Published:2014-08-15 Online:2014-08-15
  • Contact: Guiping WANG

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摘要：

【摘要】目的   观察2种视频喉镜用于阻塞性睡眠呼吸暂停综合征（OSAS）患者行悬雍垂腭咽成形术（UPPP）全麻插管的成功率和安全性，并与直接喉镜法比较。方法  将60例行UPPP患者随机分为McGrath MAC视频喉镜（M）组、GlideScope视频喉镜（G）组和SHUCMAN直接喉镜（S）组，各20例。记录并比较3组Mallampati分级、声门显露Cormark-Lehane分级，1次及3次内插管成功例数，插管前后心率、血压变化。结果   3组患者气道Mallampati分级、M组与G组喉镜暴露下声门显露Cormark-Lehane分级比较差异无统计学意义；M组和G组在声门显露分级、1次及助手协助下3次内插管成功的例数、气管插管完成即刻（T3）、插管后1min（T4）时的心率、血压变化均较S组有明显优势，组间比较差异有统计学意义（P<0.05）。M组血压变化较G组更显平稳。结论  2种视频喉镜在行UPPP患者全麻诱导插管期间均能有效显露咽喉部结构，成功率及安全性均较高，McGrath MAC视频喉镜优于GlideScope视频喉镜。

关键词: 喉镜, 麻醉, 全身, 插管法, 气管内, 睡眠呼吸暂停综合征, 视频喉镜, 悬雍垂腭咽成形术

Abstract: [Abstract] Objective   To compare intubation success rate and safety of two types of video laryngoscopes when used for anesthesia in uvulopalatopharyngoplasty surgery (UPPP) on patients with obstructive sleep apnea syndrome (OSAS). Methods   60 patients undergoing UPPP surgery between January and October of 2013 were selected and randomly divided into McGrath MAC video laryngoscope group (M group), GlideScope video laryngoscope (G group), and SHUCMAN direct laryngoscopy (S group), with 20 patients per group. Mallampati classification scores, Cormack-Lehane grade, intubation success rate, pre-intubation and post-intubation heart rate and blood pressure changes were recorded and compared. Results   Mallampati classification scores were not statistically significant between three groups, Cormack-Lehane grade between M group and G group were also not statistically significant (P>0.05). M and G group had distinct advantages in Cormack-Lehane grade, success rate in intubation, and heart rate and blood pressure at completion of intubation (T3) and 1 minute after intubation (T4), the difference is statistically significant (P<0.05). Recorded blood pressure changes were more stable in G group than M group. Conclusion   The two video laryngoscopes used in anesthesia intubation during UPPP surgery can both effectively reveal the structure of the throat, with high success rate and safety, but in this study the McGrath MAC video laryngoscope was superior to GlideScope video laryngoscope.

Key words: laryngoscopes, anesthesia, general, intubation, intratracheal, sleep apnea syndromes, video laryngoscope, 悬雍垂腭咽成形术