GlideScope视频喉镜用于经口与经鼻气管插管的临床观察

目的 观察GlideScope视频喉镜经口气管插管和经鼻气管插管的声门暴露情况、插管时间和血流动力学变化. 方法 在全身麻醉下行择期手术的患者200例,ASA Ⅰ～Ⅱ级,分为经口气管插管组和经鼻气管插管组.观察记录两组患者喉部显露分级、气管插管时间、气管插管前后的心率、血压,计算各时间点的收缩压-心率乘积（RPP）. 结果 使用GlideScope视频喉镜喉部显露分级为Ⅰ级和Ⅱ级的比例高达98%;经口插管组和经鼻插管组的插管时间分别为（43.3±9.8）s和（57.9±13.3）S,两组比较有显著差异;经口插管组的患者在气管插管时和气管插管后1～2 min内的心率、血压和RPP较麻醉诱导前显著升高,经鼻插管组的患者在气管插管后1 min时的心率和RPP较麻醉诱导前显著升高. 结论 使用GlideScope视频喉镜可改善喉部显露分级,经口气管插管所需的时间少于经鼻气管插管,而血流动力学变化强于经鼻气管插管.

Observation of Oral and Nasal Tracheal Intubation with GlideScope Video Laryngoscope

Objective To observe the laryngeal view,intubation time and hemodynamie changes of orotracheal intubation or nasotracheal intu- bation with GlideScope video laryngoscope. Methods 200 adult patients,ASA physical status I - II, requiring general anesthesia for elective surgery were allocated to the orotraeheat intubation group（ OTI group） and the nasotracheal intubation group（NTI group）. The Cormark-Le- hanc （C-L） grade,intubation time, heart rate and non-invasive blood pressure before and after intubation were recorded. The product of heart rate and systolic blood pressure rate pressure product（RPP） ] at every time point was calculated. Results C-L grade I and II were obtained in 98% of patients with GlideScope video laryngoscope. The iutubation time in NTI group was significantly longer than that in 0TI group （ 57.9 ± 13.3 ） seconds vs （43.3 ± 9. 8 ） seconds, P 〈 0.05 ]. The heart rate, non-invasive blood pressure and RPP in OTI group were sig- nificantly higher at the time of intubating and during 1 - 2 rain ＂after intuhation than those before anesthesia induction. The heart rate and RPP in NTI group were significantly bigher at the time of 1 rain after intubation than those before anesthesia induction. Conclusions The Glide- Scope video laryngoscope can improve laryngeal view. Orotracheal intubation with GlideScope video laryngoscope spends less time than naso- tracheal intubation,but causes more hemodynamic changes