视频喉镜在垂体瘤患者气管插管中的应用

摘要

Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.%目的 探讨视频喉镜在垂体瘤患者气管插管中的应用.方法 选择择期行全麻垂体瘤手术患者51例,男19例,女32例,年龄18~71岁,ASA Ⅰ或Ⅱ级.随机将患者分为Macintosh喉镜组 (M组,n=25)和视频喉镜组 (VL组,n=26).M组患者气管插管时使用Macintosh喉镜暴露声门,VL组患者使用电子视频喉镜暴露声门.测量患者颈部后仰度、张口度、甲颏距、颈围、下颌支长度、改良Mallampati分级及面罩通气难易程度.记录暴露声门时按压环状软骨的比例、Cormack-Lehane分级、二次插管的比例和插管时间.结果 VL组按压环状软骨的比例 (7.7% vs 48.0%)及Cormack-Lehane分级明显低于M组 (P<0.01),插管时间明显短于M组[(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).结论 视频喉镜用于垂体瘤患者气管插管,可显著改善声门暴露,提高插管成功率并缩短插管时间.