CAJ | 학술논문

目的介绍新型插管工具GlideScope视频喉镜在颈椎活动受限患者插管中的应用.方法 84例择期或急诊颈椎手术患者,ASAI～II级,术前存在颈椎外伤或严重的颈椎病,在快速静脉全麻诱导后先用Macintosh喉镜暴露声门进行Comack评级,然后运用视频喉镜进行插管,记录插管操作时间、次数和并发症,并测量诱导前(T_1)、诱导后(T_2)、插管时(T_3)、插管后1min(T_4)、气管插管后3 min(T_5)的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP).结果 GlideScope视频下Cor-mack分级显著改善(P<0.05),插管成功率为970.6%,插管时间为12 s~135 s,平均为(28.7±9.2)s.78例患者1次插管成功;4例患者2次插管成功;另有2例患者改为纤支镜插管;82例患者在气管插管过程中HR、SBP、DBP、ABP平稳,插管未造成呼吸道损伤.结论 GlideScope视频喉镜插管适合颈椎活动受限的困难气道,成功率高、插管迅速、安全性好.
목적 개소신형삽관공구GlideScope시빈후경재경추활동수한환자삽관중적응용.방법 84례택기혹급진경추수술환자,ASAI～II급,술전존재경추외상혹엄중적경추병,재쾌속정맥전마유도후선용Macintosh후경폭로성문진행Comack평급,연후운용시빈후경진행삽관,기록삽관조작시간、차수화병발증,병측량유도전(T_1)、유도후(T_2)、삽관시(T_3)、삽관후1min(T_4)、기관삽관후3 min(T_5)적심솔(HR)、수축압(SBP)、서장압(DBP)、평균동맥압(MAP).결과 GlideScope시빈하Cor-mack분급현저개선(P<0.05),삽관성공솔위970.6%,삽관시간위12 s~135 s,평균위(28.7±9.2)s.78례환자1차삽관성공;4례환자2차삽관성공;령유2례환자개위섬지경삽관;82례환자재기관삽관과정중HR、SBP、DBP、ABP평은,삽관미조성호흡도손상.결론 GlideScope시빈후경삽관괄합경추활동수한적곤난기도,성공솔고、삽관신속、안전성호.
Objective To describe the use of the GlideScope for patients with cervical spine immobilization. Methods 84 selective operation patients (ASA Ⅰ-Ⅱ) with cervical spine injury or severe cervical spondylosis were assigned to intubation by GlideScope videolaryngoscopy via mouth cavity after intravenous introduced general anesthesia. Prior to intubatiou all patients were given a Cormack grade by a senior anaesthetist using a Macintosh laryngoscopy. The patient was then intubated using GlideSeope videolaryngoseopy. The procedure time of intubation, number of intubating times and the side-effects were recorded. HR, SBP, DBP,MAP were measured before (T_1) and after (T_2) anesthesia induction, at the beginning (T_3), 1 minute (T_4) and 3 minutes (T_5) after tracheal intubation. Results In the GS group, Cormaek grade was improved in the majority (71/84) of patients (P<0.05). The success rate was 97.6%. The procedure time of intubation was 12 s-135 s, and the average time of intuation was (28.7±9.2)s.Intubation succeed one time in 78 patients, twice in 4 patients, and two other patients were turned to fibreoptic intubation. During the intubafion, the HR, SBP, DBP were stable. No injury of respiratory tract was observed. Conclusion GlideScope videolaryngoscopy introducing intubation seems a useful device in patients with cervical spine immobilization for its high successful rate, rapid intubation and excellent reliability.