CAJ | 학술논문

目的比较Discoscope内窥镜与GlideScope可视喉镜用于声门显露困难患者气管插管的效果.方法择期行经口气管插管的全麻患者40例,Macintosh喉镜显露Cormach-Lehane分级Ⅲ或Ⅳ级,性别不限,年龄24 ～ 78岁,采用随机数字表法,将患者随机分为2组(n=20):GlideScope可视喉镜组(G组)和Discoscope内窥镜组(D组).记录声门显露情况、声门显露时间、气管插管情况、声门显露后至气管导管置入时间和气管插管时间.术后随访患者,记录咽喉出血和咽喉疼痛的发生情况.结果与G组比较,D组声门显露时间延长,环状软骨按压率降低,声门显露至气管导管置入时间缩短,1次气管插管成功率升高(P＜0.05),1次声门显露成功率、2次声门显露成功率、2次气管插管成功率、气管插管时间、咽喉出血发生率和咽喉疼痛发生率差异无统计学意义(P＞0.05).结论与GlideScope可视喉镜比较,Discoscope内窥镜用于声门显露困难患者有助于声门的显露,且可提高气管插管的成功机率.
목적 비교Discoscope내규경여GlideScope가시후경용우성문현로곤난환자기관삽관적효과.방법 택기행경구기관삽관적전마환자40례,Macintosh후경현로Cormach-Lehane분급Ⅲ혹Ⅳ급,성별불한,년령24 ～ 78세,채용수궤수자표법,장환자수궤분위2조(n=20):GlideScope가시후경조(G조)화Discoscope내규경조(D조).기록성문현로정황、성문현로시간、기관삽관정황、성문현로후지기관도관치입시간화기관삽관시간.술후수방환자,기록인후출혈화인후동통적발생정황.결과 여G조비교,D조성문현로시간연장,배상연골안압솔강저,성문현로지기관도관치입시간축단,1차기관삽관성공솔승고(P＜0.05),1차성문현로성공솔、2차성문현로성공솔、2차기관삽관성공솔、기관삽관시간、인후출혈발생솔화인후동통발생솔차이무통계학의의(P＞0.05).결론 여GlideScope가시후경비교,Discoscope내규경용우성문현로곤난환자유조우성문적현로,차가제고기관삽관적성공궤솔.
Objective To compare the efficacy of Discoscope endoscope and GlideScope video laryngoscope for difficult glottis exposure.Methods Forty adult patients of both sexes scheduled for elective surgery under general anesthesia whose glottis was not visible at laryngoscopy (grade Ⅲ or Ⅳ according to Cormach-Lehane Grading of laryngoscopic view) were randomized into 2 groups (n =20 each):group GlideScope video laryngoscope (group G) and group Discoscope endoscope (group D).The glottis exposure time,intubating conditions,time from exposure of glottis to completion of tracheal intubation and incidence of postoperative sore throat and throat bleeding were recorded and compared between the 2 groups.Results Compared with group G,the glottis exposure time was significantly longer,the rate of backward pressure of cricoid cartilage lower,the time from exposure of glottis to completion of tracheal intubation shorter and the success rate of tracheal intubation at first attempt higher (P ＜ 0.05).There was no significant difference in the success rate of tracheal intubation at second attempt and postoperative incidence of sore throat and throat bleeding between the 2 groups(P ＞ 0.05).Conclusion DiscoScope endoscope is superior to GlideScope video laryngoscope in the management of difficult intubation in term of glottis exposure and success rate of tracheal intubation at first attempt.