CAJ | 학술논문

目的：比较普通喉镜、Glidescope视频喉镜、Lightwand光棒三种插管方法在一次性插管成功率、插管时间、并发症及患者血流动力学影响之间的差异。方法150例维吾尔族需全身麻醉气管插管完成择期手术的男性患者。采用数字表法随机分为三组：普通喉镜组（P组）、Glidescope视频喉镜组（G组）、Lightwand光棒组（L组）,每组各50例。插管前评估患者的张口度和甲颏距离，张口度小于3.0cm或甲颏距离小于6.5cm标记为潜在的困难气道。记录患者入手术室（T0），气管插管前（T1），气管插管后1min（T2）三个时间点MAP、HR数值；标注每组当中张口度小于3.0cm或甲颏距离小于6.5cm潜在困难气道病例的例数；统计一次性成功率、失败率、插管时间、并发症(口咽损伤、声音嘶哑及咽痛)的发生情况。结果与同组T1时刻组内比较，P组与G组两组患者插管成功后1min（T2）MAP明显升高，HR显著加快；与L组组间比较，P、G两组患者T2时刻MAP、HR数值较L组均存在着显著差异(P＜0.05)。三组之间一次性成功率、插管时间无统计学差异；P组较L组失败率高、术后发生并发症的可能性更大。预计可能困难插管患者插管过程中具体情况：与L组比较，P组一次性成功率极低、失败率高、插管时间显著延长、术后发生口咽损伤、声音嘶哑及咽痛的几率高。结论在围麻醉期解决困难气道方面，光棒引导的气管插管法具有成本低廉、便于携带、成功率高、术后并发症少、所需专业技术要求不高的优势，值得在新疆自治区广大基层医院麻醉手术科推广和运用。
목적：비교보통후경、Glidescope시빈후경、Lightwand광봉삼충삽관방법재일차성삽관성공솔、삽관시간、병발증급환자혈류동역학영향지간적차이。방법150례유오이족수전신마취기관삽관완성택기수술적남성환자。채용수자표법수궤분위삼조：보통후경조（P조）、Glidescope시빈후경조（G조）、Lightwand광봉조（L조）,매조각50례。삽관전평고환자적장구도화갑해거리，장구도소우3.0cm혹갑해거리소우6.5cm표기위잠재적곤난기도。기록환자입수술실（T0），기관삽관전（T1），기관삽관후1min（T2）삼개시간점MAP、HR수치；표주매조당중장구도소우3.0cm혹갑해거리소우6.5cm잠재곤난기도병례적례수；통계일차성성공솔、실패솔、삽관시간、병발증(구인손상、성음시아급인통)적발생정황。결과여동조T1시각조내비교，P조여G조량조환자삽관성공후1min（T2）MAP명현승고，HR현저가쾌；여L조조간비교，P、G량조환자T2시각MAP、HR수치교L조균존재착현저차이(P＜0.05)。삼조지간일차성성공솔、삽관시간무통계학차이；P조교L조실패솔고、술후발생병발증적가능성경대。예계가능곤난삽관환자삽관과정중구체정황：여L조비교，P조일차성성공솔겁저、실패솔고、삽관시간현저연장、술후발생구인손상、성음시아급인통적궤솔고。결론재위마취기해결곤난기도방면，광봉인도적기관삽관법구유성본저렴、편우휴대、성공솔고、술후병발증소、소수전업기술요구불고적우세，치득재신강자치구엄대기층의원마취수술과추엄화운용。
Objective To examine the different effects of ordinary laryngoscope, Glidescope and Lightwand in the progress of intubation to male pations of Uyghur nationality. Methods 150 patients undergoing selective operation in the xinjia Uyghur ng Uyghur Autonomous Region of Yi Ning hospital were randomly assigned into three groups ( n=50 each ):group ordinary laryngoscope (group P );group Glidescope (group G ) and group Lightwand (group L ).Both interincisor distance less than 3.0cm and thyromental distance less than 6.5cm were considered as potential difficult airway. One time success rate, failure rate,time needed and complication were recorded. Results Compared with T1, both MAP and HR rised significantly at T2 in group P and group G;Compared with group L, group P and group G had evidently dirrerences in MAP and HR at T2. Conclusion In the aspect of solving difficult intubation, Lightwand had the superiorities of cheap cost,convenient carry,high success rate, low complications, needing not professional technology and it should be popularizd.