Bonfils纤维气管镜用于难以预料的困难气管插管的研究

摘要

Objective To prospectively evaluate the effectiveness of the Bonfils intubation fiberscope for tracheal intubation in patients with an unexpected difficult airway.Methods Twenty- one patients who underwent CABG surgery were enrolled in the study, if conventional blade laryngoscopy by a board certified anesthesiologist failed after two attempts. The overall success rate, time for intubation, and a set of clinical predictors of a difficult airway (mallampafi score, thyeomental distance, mouth opening, mobility of the atlanto - occipital junction)were recorded.Results The success rate of tracheal intubetion on the first attempt was 95% (20 of 21 patients), with only one patient was intubated successfully on the second attempt. The mean time for intubation (50 ± 25) seconds.Conclusions Tracheal intubetion using the Bonfils intubation fiberscope proves to be a simple and effective technique for the management of the unexpected difficult airway.%目的难以预料和失败的困难气管插管是引起麻醉并发症和麻醉病死率的重要因素.本研究探讨Bonfils纤维气管镜用于处理难以预料的困难气管插管的价值.方法21例行体外循环下冠状动脉搭桥术的患者,经一名高年资的麻醉医生使用普通咽喉镜两次插管失败后作为研究对象.测定Bonfils纤维气管镜插管的成功率和插管时间,同时测定判断困难气管插管的临床指标:甲颏距离、Mal1ampti分类、张口度、寰枕关节的活动度等.结果除外一个患者第二次插管成功外,第一次插管的成功率是95%.平均插管时间(50±25)秒.结论应用Bonfils纤维气管镜插管是处理难以预料困难气管插管的简单而有效的方法.