Airtraq喉镜清醒插管在阻塞性睡眠呼吸暂停综合征中的临床应用

摘要

目的:探讨Airtraq喉镜清醒插管在OSAS中的临床应用价值.方法:择期行全麻下UPPP术OSAS患者42例,按随机数字表法分为Airtraq喉镜组和Macintosh喉镜组各21例.麻醉诱导后分别使用Airtraq喉镜和Macintosh喉镜显露声门行清醒气管插管.结果:Airtraq喉镜组总插管时间短于Macintosh喉镜组(P<0.05),插管成功率高与Macintosh喉镜组(P<0.05),IDS评分低与Macintosh喉镜组(P<0.05).与T1相比,两组T2时SBP、DBP、RPP明显下降(P<0.05),HR变化不明显(P>0.05).与T2相比,Airtraq喉镜组T3时各血流动力学指标无明显变化(P>0.05),Macintosh喉镜组T3时各血流动力学指标明显升高(P<0.05).Airtraq喉镜组T3时的HR和RPP明显低与Macintosh喉镜组(P<0.05).Airtraq喉镜组声门完全显露率(I级)明显高与Macintosh喉镜组(P<0.05).Macintosh喉镜组发生咽喉损伤1例,咽痛1例,Airtraq喉镜组无1例发生.结论:在OSAS预计困难气道患者中应用Airtraq喉镜清醒插管,操作便捷,插管成功率高,血流动力学反应轻,声门显露好,并发症少,相比Macintosh直接喉镜,具宵明显的优势.%Objective: To investigate the clinical application value of awake intubation with Airtraq laryngoscope in OSAS.Methods: 42 OSAS patients who received UPPP surgery scheduled for elective operation under general anesthesia with the tracheal intubation, were randomly divided into Airtraq laryngoscope group and Macintosh laryngoscope group with 20 patients in each group. After anesthetic induce,perform awake endotracheal intubation using Airtraq videolaryngoscope and Macintosh direct laryngoscope to expose glotiss respectively.Results:Compared with the Macintosh laryngoscope group,the insertion time of catheter was shorter in Airtraq laryngoscope group(P＜0.05),the tracheal intubation success ratio was higher in Airtraq laryngoscope group(P＜0.05),and the IDS score was lower in Airtraq laryngoscope group(P＜0.05).Compared with T1,SBP,DBP and RPP in two groups decreased significantly(P＜0.05),the change of HR was not remarkableat T2(P＜0.05);Compared with T2,the was no significant change of each hemodynamic index in Airtraq laryngoscope group at T3 (P＜0.05),while in Macintosh larygoscope group,each hemodynamic index increased significantly at T3 (P＜0.05).HR and RPP of Airtraq laryngoscope group were markedly lower than that of Macintosh laryngoscope group at T3(P＜0.05).The complete exposure rate of glotiss (GradeⅠ) in Airtraq laryngoscope group were markedly higher than that of Macintosh laryngoscope group (P＜0.05).One throat injury and one pharyngalgia occurred in Macintosh laryngoscope group,while no case occurred in Airtraq laryngoscope group.Conclusion:Compared with Macintosh direct laryngoscope,the awake intubation using Airtraq laryngoscope in OSAS patients with an anticipated difficult airway has remarkable advantages,which provides high intubation success ratio,slight reaction of hemodynaics,a clear view of glottis,few complications and is simple to perform.