McGrath-5型视频喉镜与直接喉镜用于双腔支气管插管的比较

摘要

目的：探讨 McGrath-5型视频喉镜在双腔导管气管插管的临床应用效果。方法选择择期在全身麻醉下行胸科手术患者80例，采用随机数字表法，将其随机分为2组：McGrath-5型视频喉镜组（A 组，n ＝40）和 Macintosh 喉镜组（B 组，n ＝40）。常规诱导后分别用2种喉镜引导经口插管，对2组患者一次插管成功率、插管总时间、声门暴露级别、插管并发症发生情况和血流动力学指标[诱导前（T0）、诱导后2 min （T1）、置入喉镜显露声门时（T2）、导管进入声门即刻（T3）、插管后1 min （T4）、插管后3 min （T5）各时间点记录患者收缩压、舒张压及心率的变化]进行分析。结果A 组患者一次插管成功率、暴露满意度均明显高于 B 组（P 均＜0.05），插管总时间明显短于B 组（P ＜0.05）；2组患者 T1、T4、T5时点的收缩压、舒张压和心率较 T0时点均明显降低（P 均＜0.05），A 组患者 T2时点收缩压、舒张压和心率均明显低于 B 组（P 均＜0.05）。结论与 Macintosh喉镜相比，McGrath-5型视频喉镜引导经口双腔导管插管明显改善声门显露情况，提高一次插管成功率，缩短插管总时间，适合临床应用。%Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and Macintosh laryngoscope.Methods Eighty patients scheduled for elective thoracic surgery under general anesthesia were divided into two groups using random number table method:McGrath-5 video-laryngoscope (group A,n =40)and Macintosh laryngoscope groups (group B,n =40).All patients were intubated by two laryngoscopes correspondingly after conventional induction.The success rate of the first intubation,total intubation time,grading of glottic exposure,the incidence of intubation complications and hemodynamic parameters (The changes in systolic and diastolic pressure and heart rate)were recorded be-fore induction (T0 ),2 min after induction (T1 ),glottic exposure upon laryngoscope insertion (T2 ),immedi-ately after intubation (T3 ),1 min (T4 )and 3 min (T5 )after intubation.Results The success rate of the first intubation and the satisfaction rate of glottic exposure in group A were significantly higher than those in group B (both P <0.05).Furthermore,the total intubation time in group A was significantly shorter than that in group B (P <0.05).The systolic and diastolic pressure and heart rate at T1 ,T4 and T5 were dramatically reduced compared with those measured at T0 in both groups (all P <0.05).The systolic and diastolic pressure and heart rate at T2 in group A were considerably lower than those in group B (all P <0.05).Conclusions Compared with the Macintosh laryngoscope,double-lumen tube intubation by McGrath-5 video-laryngoscope can significantly improve glottic exposure,enhance the success rate of the first intubation and shorten the total intu-bation time,which deserves widespread application in clinical practice.