可视喉镜联合光杖在临床麻醉气管插管带教中的效果比较

摘要

目的 探讨可视喉镜联合光杖在气管插管中对实习学生带教中的作用.方法 选取2016年9月～2017年4月在武汉大学人民医院麻醉科实习的24名本科学生,按照随机数字表法分为四组,普通气管插管组(G组)、可视喉镜气管插管组(A组)、光杖气管插管组(B组)、可视喉镜联合光杖气管插管组(C组),每组6名.分别在气管插管实践操作后第1、3、6个月的最后一周,应用Mallampati气道分级及Comark-Lehane喉头分级对患者气道进行评估,分为困难气道组和非困难气道组,每组各12名.对四组实习学生气管插管进行评估,记录插管成功率及插管所用时间.结果 实习后第1个月,对于非困难气道患者,四组插管成功率差异无统计学意义(P＞0.05),但相较于其余三组,B组插管时间较长(P＜0.05);对于困难气道患者,C组插管成功率高于其他三组,四组插管时间均显著延长(P＜0.05).实习后第3个月,对于非困难气道患者,四组插管成功率和插管时间比较差异均无统计学意义(P＞0.05);对于困难气道患者,相较于实习后第1个月四组插管成功率均有所上升,插管时间均有所减少,但C组插管成功率仍高于其他三组(P＜0.05).实习后第6个月,对于困难气道患者,A、B、C三组插管成功率均高于G组,C组插管成功率最高(P＜0.05).结论 可视喉镜联合光杖可以迅速提高实习学生对患者气管插管的成功率,并在困难气道患者插管过程中具有较大优势.%Objective To explore the comparative study of glidescope combined with glowstick in trachea intubation in intern students of clinical anesthesia.Methods Twenty-four intern students from September 2016 to April 2017 in Anesthesiology Department of Renmin Hospital of Wuhan University were randomly allocated into 4 groups by random numbers table method:normal intubation group (group G),glidescope intubation group (group A),glowstick intubation group (group B) and glidescope combined with glowstick intubation group (group C),with 6 each group.Before trachea intubation,according to the air way assessed by Mallampati and Comark-Lehane patients were divided into normal air way and difficult air way,12 in each group.The successful rate and time of trachea intubation at the last week of 1,3months and 6 months were recorded.Results After 1 month,the successful rate of intubation was no difference between four groups,however,the time of intubation was little longer in group B on normal air way (P ＜ 0.05),the successful rate of intubation in group C were higher than other groups,all groups need more time for intubation on difficult air way (P ＜ 0.05).After 3 months,there were no difference between four groups on normal air way (P ＞ 0.05),the successful rate of intubation in four groups were increased than 1 month ago,but group C was still higher than other groups on difficult air way (P ＜ 0.05).After 6 months,the successful rate of intubation in A,B and C groups was higher than that of the group G,group C was the highest group on difficult air way (P ＜ 0.05).Conclusion Glidescope combined with glowstick can quickly improve the successful rate of trachea intubation for the abecedarian,and it has a great advantage in the intubation of patients with difficult air way.