CAJ | 학술논문

目的评估可视喉镜在急诊气管插管术中的临床价值和安全性.方法选取2010年1月至2010年12月首都医科大学附属北京朝阳医院(京西院区)急诊中心需紧急气管插管的患者79例,按就诊顺序随机(随机数字法)分为普通喉镜组(Timesco喉镜)(A组)40例和可视喉镜组(GlideScope可视喉镜)(B组)39例.观察两组患者C/L喉镜显露分级、插管时间、插管成功率以及不良反应；记录给药前(t0)、给药后/插管前(t1)、插管时(t2)、插管后2 min(t3)各时间点的心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、脉搏血氧饱和度(SpO2).结果 (1) C/L喉镜显露分级(Ⅰ+Ⅱ/Ⅲ+Ⅳ)A组明显高于B组(P＜0.05)；(2)B组插管时间为(35.6±12.7)8,明显短于A组插管时间(58.3±13.5)s；B组一次插管成功率(84.6％)明显高于A组(52.5％)(P＜0.05)；(3)与B组比较,A组患者t2、t3时间点HR及MAP增加显著(P＜0.05)；(4)A组患者躁动、呛咳、憋气和损伤等不良反应明显高于B组(P＜0.05).结论可视喉镜用于急诊危重症气管插管术,改善喉镜显露分级、缩短插管时间,提高一次插管成功率,降低不良反应.
목적 평고가시후경재급진기관삽관술중적림상개치화안전성.방법 선취2010년1월지2010년12월수도의과대학부속북경조양의원(경서원구)급진중심수긴급기관삽관적환자79례,안취진순서수궤(수궤수자법)분위보통후경조(Timesco후경)(A조)40례화가시후경조(GlideScope가시후경)(B조)39례.관찰량조환자C/L후경현로분급、삽관시간、삽관성공솔이급불량반응；기록급약전(t0)、급약후/삽관전(t1)、삽관시(t2)、삽관후2 min(t3)각시간점적심솔(HR)、평균동맥압(MAP)、호흡빈솔(RR)、맥박혈양포화도(SpO2).결과 (1) C/L후경현로분급(Ⅰ+Ⅱ/Ⅲ+Ⅳ)A조명현고우B조(P＜0.05)；(2)B조삽관시간위(35.6±12.7)8,명현단우A조삽관시간(58.3±13.5)s；B조일차삽관성공솔(84.6％)명현고우A조(52.5％)(P＜0.05)；(3)여B조비교,A조환자t2、t3시간점HR급MAP증가현저(P＜0.05)；(4)A조환자조동、창해、별기화손상등불량반응명현고우B조(P＜0.05).결론 가시후경용우급진위중증기관삽관술,개선후경현로분급、축단삽관시간,제고일차삽관성공솔,강저불량반응.
Objective To assess the safety and clinical values of video-laryngoscope in spontaneous respiration tracheal intubation for emergency patients. Methods Seventy-nine patients,who needed the endotracheal intubation,were recruited in our department between January 2010 and December 2010,and were randomly ( random number) divided into two groups according to consultative sequence.Forty patients (group A ) were operated with traditional laryngoscope and thirty-nine patients (group B ) with videolaryngoscope.The operative time and success rate of tracheal intubation,Cormack-Lehane classification,as well as adverse events,were recorded.The heart rate ( HR ),mean arterial blood pressure ( MAP),respiratory rate ( RR ),and saturation of pulse oxygen ( SpO2 ) were observed pre-operation,during operation and 2 min post-operation.Results ( 1 ) The Cormack-Lehane classification in group A were significantly lower than in group B. (2) The operative time of tracheal intubation in group B was significantly less than that in group A [(35.6+12.7) svs. (58.3 ± 13.5) s; P＜0.05] ; and one-time success rate of tracheal intubation in group B was higher than that in group A ( 84.6％ vs.52.5％ ; P ＜0.05).(3) Compared to group B,the HR and MAP in Group A were significantly increased at t2 and t3 ( P ＜ 0.05 ). ( 4 ) The adverse events,including restlessness,bucking and injury,were significantly decreased in group B than those in group A ( P ＜ 0.05 ).Conclusions The video-laryngoscope used in spontaneous respiration tracheal intubation,could improve Cormack-Lehane classification,short operative time,enhance one-time success rate and reduce adverse evevnts.