CAJ | 학술논문

目的观察、评价TruviewTM EVO2光学喉镜在急诊抢救气管插管中的临床效果.方法 44例在急诊室进行紧急气管插管的患者,随机(随机数字法)分为观察组(应用TruviewTM EVO2光学喉镜进行气管插管)和对照组(普通喉镜进行气管插管),每组22例.观察指标包括两组患者喉部显露的C/L(Cormack-Lehane)分级,插管时间,插管次数,SpO2的最低下降值和术后并发症；计算IDS评分(intubation difficulty scale score)和比较总体有效率.结果两组喉镜插管时间(24.04±6.56)s与(21.97±8.92)s相比差异无统计学意义(P＞0.05).观察组C/L分级(Ⅰ级∶Ⅱ级∶Ⅲ级∶Ⅳ级为10∶9∶3∶0)显著优于对照组(3∶7∶9∶3)(P＜0.01)；观察组插管次数(1次∶2次∶3次为17∶5∶0)显著优于对照组(9∶8∶5)(P＜0.01)；观察组气管插管过程中SpO2的最低下降值(97.31±1.64)％明显高于对照组(92.03±5.39)％；观察组术后并发症发生率较低,IDS评分(0.68±0.38)分显著低于对照组(2.54±1.49)分,及总体有效率(86.36％)明显优于对照组(45.45％),(P＜0.01).结论光学喉镜应用于急诊气管插管中,声门暴露效果明显,C/L分级有效降低,并发症发生少,有效地增加了气管插管的成功率.
목적 관찰、평개TruviewTM EVO2광학후경재급진창구기관삽관중적림상효과.방법 44례재급진실진행긴급기관삽관적환자,수궤(수궤수자법)분위관찰조(응용TruviewTM EVO2광학후경진행기관삽관)화대조조(보통후경진행기관삽관),매조22례.관찰지표포괄량조환자후부현로적C/L(Cormack-Lehane)분급,삽관시간,삽관차수,SpO2적최저하강치화술후병발증；계산IDS평분(intubation difficulty scale score)화비교총체유효솔.결과 량조후경삽관시간(24.04±6.56)s여(21.97±8.92)s상비차이무통계학의의(P＞0.05).관찰조C/L분급(Ⅰ급∶Ⅱ급∶Ⅲ급∶Ⅳ급위10∶9∶3∶0)현저우우대조조(3∶7∶9∶3)(P＜0.01)；관찰조삽관차수(1차∶2차∶3차위17∶5∶0)현저우우대조조(9∶8∶5)(P＜0.01)；관찰조기관삽관과정중SpO2적최저하강치(97.31±1.64)％명현고우대조조(92.03±5.39)％；관찰조술후병발증발생솔교저,IDS평분(0.68±0.38)분현저저우대조조(2.54±1.49)분,급총체유효솔(86.36％)명현우우대조조(45.45％),(P＜0.01).결론 광학후경응용우급진기관삽관중,성문폭로효과명현,C/L분급유효강저,병발증발생소,유효지증가료기관삽관적성공솔.
Objective To evaluate the value of TruviewTM EVO2 optical laryngoscope for emergency endotracheal intubation in the clinical application.Methods Forty-four patients in need for emergency endotracheal intubation were randomly (random number) divided into two groups:the observation group (TruviewTM EVO2 optical laryngoscope for tracheal intubation,n =22) and the control group (ordinary laryngoscope for tracheal intubation,n =22).Parameters recordered included C/L (Cormack-Lehane)grade,the time taken for successful intubation,tracheal intubation times,lowerest SpO2 during the intubation and the incidences of complications after intubation.IDS (intubation difficulty scale) scores were calculated and the total effective rates were compared.Results The data showed that there were no significant differences in the duration of the successful endotracheal intubation attempts between the two groups,respectively (24.04 ±6.56) s and (21.97 ±8.92) s,P ＞0.05.The C/L grade with the observation group was 10∶ 9∶ 3∶0 (Ⅰ ∶ Ⅱ ∶ Ⅲ∶ Ⅳ),which was significantly better than that with the control group (3∶ 7∶ 9∶ 3,P ＜0.01).The tracheal intubation times of the observation group was 17∶ 5∶0 (one time∶ two times∶ three times),which was significantly better than that of the control group (9∶ 8∶ 5,P ＜0.01).The minimum of SpO2 in the observation group (97.31 ± 1.64)％ was significantly higher than that in the control group (92.03 ± 5.39)％,(P ＜ 0.01).The incidence of complications after intubation was lower in the observation group.The IDS score in the observation group (0.68 ± 0.38) was much lower than those in the control group (2.54 ± 1.49),(P ＜ 0.01).In addition,the total effective rate of the observation group (86.36％) was significantly higer than that in the control group (45.45％),(P ＜0.01).Conclusions Using optical laryngoscope for emergency endotracheal intubation could facilitate the glottis exposure and reduce C/L grade effectively.It could lead to lower the incidence of complications and increase the success rate of tracheal intubation.