CAJ | 학술논문

目的：探讨TruviewTM EVO2视频喉镜在烧伤后面颈部瘢痕患者困难气道管理中应用价值。方法选择烧伤后面颈部瘢痕需全麻插管下手术和困难气道评估Lemon≥2分患者，根据住院序列单双号分为TruviewTM EVO2视频喉镜组（ T组）和Macintosh 直接喉镜组（ M组）。两组均采用全麻诱导后尝试性插管，对直接影响插管的面颈部瘢痕而且明显不能用传统喉镜者先行瘢痕松解。观察记录声门暴露时间、插管成功的尝试次数、插管时间、成功与否、有无助手辅助、镜下Cormack分级及插管成功率。结果 Lemon≥2分的118例，M组57例，T组61例。 M组和T组Lemon 分分别为（3．46±1．73）和（3．22±1．12）。 T组声门显露Cormack分级均为Ⅰ～Ⅱ级（100％），而 M组Ⅰ～Ⅱ级仅28例（31．6％）。 T组插管次数、声门暴露时间、插管总时间及助手辅助情况明显好于或短于M组（ P＜0．01），但T组导管置入时间明显长于M组（ P＜0．01）。 M组首次插管35例成功（61．4％），T组首次插管61例成功（100％，P＜0．01）。结论面颈部瘢痕困难气道中，TruviewTM EVO2视频喉镜显露声门较好，插管相对容易和安全。
목적：탐토TruviewTM EVO2시빈후경재소상후면경부반흔환자곤난기도관리중응용개치。방법선택소상후면경부반흔수전마삽관하수술화곤난기도평고Lemon≥2분환자，근거주원서렬단쌍호분위TruviewTM EVO2시빈후경조（ T조）화Macintosh 직접후경조（ M조）。량조균채용전마유도후상시성삽관，대직접영향삽관적면경부반흔이차명현불능용전통후경자선행반흔송해。관찰기록성문폭로시간、삽관성공적상시차수、삽관시간、성공여부、유무조수보조、경하Cormack분급급삽관성공솔。결과 Lemon≥2분적118례，M조57례，T조61례。 M조화T조Lemon 분분별위（3．46±1．73）화（3．22±1．12）。 T조성문현로Cormack분급균위Ⅰ～Ⅱ급（100％），이 M조Ⅰ～Ⅱ급부28례（31．6％）。 T조삽관차수、성문폭로시간、삽관총시간급조수보조정황명현호우혹단우M조（ P＜0．01），단T조도관치입시간명현장우M조（ P＜0．01）。 M조수차삽관35례성공（61．4％），T조수차삽관61례성공（100％，P＜0．01）。결론면경부반흔곤난기도중，TruviewTM EVO2시빈후경현로성문교호，삽관상대용역화안전。
Objective To explore application of the Truview TM EVO2 video laryngoscope in management of difficult airway in patients with the neck burn scar .Methods Surgical patients under general anesthesia and intubation were divided into Truview TM EVO2 video (Group T) and Macintosh laryngoscope (Group M).The attempted intubation was carried out after induction of general anesthesia in both groups .The scars first were released in patients with cervicofacial scar that can not carry out intubation with tradi -tional laryngoscope .Observing and recording contents included Cormack scale intubation time , times, succeed cases and so on .Re-sults There were 118 patients with Lemon ≥2 points, 57 in group M and 61 in group T.Lemon score (3.46 ±1.73) and (3.22 ± 1.12) in group M and T.The glottis exposure of 61 patients were all Cormack grade ⅠorⅡ(100%) in group T.The glottis expo-sure of 28 patients (31.6%) were gradeⅠorⅡin group M.The glottis exposure time , number of attempt intubation , total time were significantly better in group T than in group M (P<0.01).The intubation time takes significantly longer in group T than in group M (P<0.01).Intubation were successful in 35 of 57 patients (61.4%) in group M.The intubation success rate (100%) was signifi-cantly higher in group T than in group M (P<0.01).Conclusion In management of difficult airway in patients with the neck burn scar, TruviewTM EVO2 video laryngoscope for glottis exposure , intubation is relatively easy and safe .