摘要:目的:评价Bonfils纤维硬镜用于困难气道插管的临床价值.方法:择期行全麻气管插管手术病人40例,随机分为两组:B组(Bonfils纤维硬镜插管组,n=20)和N组(普通Macintosh喉镜插管组,n=20).术前对病人行气道评估,只要符合以下1项者纳入本研究:Mallampati评级≥Ⅲ级;甲颏距离<6 cm或不足3横指;张口度<3.5 cm;颈部活动受限或颈椎不稳定等.常规麻醉诱导后B组和N组分别用Bonfils纤维硬镜和普通Macintosh喉镜插管.记录诱导前、插管前、插管后的血流动力学变化.依照硬镜或喉镜显露声门的难易程度评价插管情况,记录插管时间和成功率,随访插管后的不良反应.结果:与N组相比,B组插管后的血压和心率波动较小,成功率高,不良反应少.结论:Bonfils纤维硬镜在困难气道插管中操作简单,安全有效.%Objective: To assess the clinical efficacy of Bonfils rigid fiberoptic stylet in patients with anticipated difficult airways. Methods: Forty patients scheduled for surgery under general anesthesia requiring the tra-cheal intubation were randomly allocated to group B ( Bonfils Retromolar Intubation Fiberscope, Bonfils, Karl Storz Endoscopy, Tuttlingen, Germany , n ~ 20 ) and group N ( conventional Macintosh laryngoscope, n = 20). By preoperative assessment, patients were included in this study if they had any one of the following signs of difficult airways: Mallampti scores class 3 , thyromental distance < 6 cm, mouth opening < 3. 5 cm, limited mobility at the atlanto-occipital joint, or patients with unstable cervical spine. After conventional anesthesia induction, Bonfils rigid fiberoptic stylet was used in group B and conventional Macintosh laryngoscope in group C, with recording the variations of hemodynamics before induction, pre-intubation and post-intubation. Also, patients in the two groups were kept regarding the visualization of the vocal cords, duration of intubation, number of attempts and postoperative adverse effects, by use of Bonfils intubation fiberscope or conventional Macintosh laryngoscope. Results: Group B had minor fluctuation in SBP,DBP and HR,fewer number of attempts and less adverse effects as compared with group B by the baseline before intubation. Conclusion: Bonfils rigid intubation fiberscope is easy to perform, safe and efficacious for patients with anticipated difficult airways.