| 李超，旷昕，胡晓玲，李玉成，郭立萍.纤支镜与可视喉镜在困难气道双腔管插管中的比较.[J].中南医学科学杂志.,2013,41(1):35-37. |
| 纤支镜与可视喉镜在困难气道双腔管插管中的比较 |
| The Comparison of Double-lumen Tube Intubation With Bronchoscopy to Video Laryngoscopes in Patients With Difficult Airway |
| 投稿时间：2012-06-19 |
| DOI： |
| 中文关键词: 纤维支气管镜 可视喉镜 双腔支气管导管 |
| 英文关键词:fiberoptic bronchoscopy video laryngoscope double-lumen bronchial tube |
| 基金项目:湖南省教育厅(09C843);湖南省中医药科研计划项目(2010088). |
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| 中文摘要: |
| 目的比较在困难气道患者行双腔支气管插管时，使用纤支镜与可视喉镜插管的差异。方法择期行胸腔镜手术患者48例，ASA评级Ⅰ～Ⅱ级，插管困难程度分级（Mallampati分级）Ⅲ～Ⅳ级，回顾性均分为纤支镜组和可视喉镜组。纤支镜组直接运用纤支镜先引导双腔支气管插入气道，再行纤支镜对位；可视喉镜组先运用可视喉镜插管，再行纤支镜对位。观察两组的插管时间、一次性插管成功率、心率（HR）及收缩压（SBP）的变化、口腔咽喉部损伤情况及术后咽喉部不适感。结果两组在插管时间上差异无显著性；一次性成功率纤支镜组为100%，可视喉镜组为95%，差异无显著性(P>0.05)；插管前后可视喉镜组HR、SBP变化幅度较纤支镜组明显增加，差异有显著性(P<0.05)；可视喉镜组口腔咽喉部损伤例数（11例）比纤支镜组多（2例），差异有显著性(P<0.05)；可视喉镜组术后咽喉不适感患者（14例）多于纤支镜组（7例）(P<0.05)。结论在困难气道行双腔支气管插管中直接使用纤支镜引导及对位比先使用可视喉镜插管后运用纤支镜对位具有损伤更小、刺激更轻等优势，对患者更有利，是困难气道双腔支气管插管的首选方法。 |
| 英文摘要: |
| ObjectiveTo compare the differences between using bronchoscopy or video laryngoscopes to do double-lumen tube intubation in patients with difficult airway.Methods48 patients undergoing elective thoracoscopic surgery(ASA I ～ II,Mallampati classification III ～ IV)were randomly divided into two groups (bronchoscopy group and video laryngoscopes group),with 24 cases in each group.In bronchoscopy group,bronchoscopy was directly used to guide the double-lumen tube bronchial intubation,and then to check the placement of the tube;In video laryngoscopes group,video laryngoscopy was first used to guide the intubation,and then the placement of the tube was checked by bronchoscopy.The intubation time,one-time intubation success rate,heart rate (HR) and systolic blood pressure (SBP),oral throat injury and postoperative throat discomfort were observed in both groups.ResultsThere were no statistical differences between bronchoscopy group and video laryngoscopes group in the intubation time or one-time success rate (P>0.05);the HR and SBP after intubation were higher in video laryngoscopes group than in bronchoscopy group(P<0.05);there were more oral throat injury cases（11 vs 2）（P<0.01） and postoperative throat discomfort patients (P<0.05) in video laryngoscopes group than in bronchoscopy group（14 vs7）.ConclusionFor patients with difficult airway,using bronchoscopy to guide the double-lumen bronchial intubation directly had less injury and stimulation than using video laryngoscopy. |
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