HC可视喉镜在重症清醒危重患者气管插管中的应用效果与安全性观察
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摘要
目的:观察HC可视喉镜在重症清醒危重患者气管插管中的应用效果与安全性。方法:选取2016年10月-2017年12月本院收治的清醒危重患者78例。根据插管方式的不同将其分为对照组(普通喉镜组)和观察组(HC可视喉镜组),各39例。比较两组的暴露声门时间、插管时间、插管成功率、声门暴露效果、不良反应发生率、插管前后的血流动力学及应激激素水平。结果:观察组的暴露声门时间及插管时间均短于对照组,插管成功率及声门暴露效果均优于对照组,不良反应发生率低于对照组,插管后即刻及插管后2 min的血流动力学及应激激素水平均低于对照组,比较差异均有统计学意义(P<0.05)。结论:HC可视喉镜在重症清醒危重患者气管插管中的应用效果较好,安全性较高,临床应用价值更高。
Objective:To observe the application effect and safety of HC visual laryngoscope in the tracheal intubation of sober and critical patients.Method:A total of 78 sober and critical patients from October 2016 to December 2017 in our hospital were selected.According to the different ways of intubation,they were divided into control group(ordinary laryngoscope group)and observation group(HC visual laryngoscope group),39 cases in each group.The exposure glottis time,intubation time,success rates of intubation,exposure glottis effect,incidence of adverse reaction,hemodynamics and stress hormones levels before and after intubation of two groups were compared.Result:The exposure glottis time and intubation time of observation group were shorter than those of control group,the success rates of intubation and the effect of exposure glottis were better than those of control group,incidence of adverse reaction was lower than that of control group,the hemodynamics and stress hormones levels of observation group at once and 2 min after the intubation were all lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The application effect of HC visual laryngoscope in the tracheal intubation of sober and critical patients is better,and the safety is higher,so its clinical application value is higher.
Objective:To observe the application effect and safety of HC visual laryngoscope in the tracheal intubation of sober and critical patients.Method:A total of 78 sober and critical patients from October 2016 to December 2017 in our hospital were selected.According to the different ways of intubation,they were divided into control group(ordinary laryngoscope group)and observation group(HC visual laryngoscope group),39 cases in each group.The exposure glottis time,intubation time,success rates of intubation,exposure glottis effect,incidence of adverse reaction,hemodynamics and stress hormones levels before and after intubation of two groups were compared.Result:The exposure glottis time and intubation time of observation group were shorter than those of control group,the success rates of intubation and the effect of exposure glottis were better than those of control group,incidence of adverse reaction was lower than that of control group,the hemodynamics and stress hormones levels of observation group at once and 2 min after the intubation were all lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The application effect of HC visual laryngoscope in the tracheal intubation of sober and critical patients is better,and the safety is higher,so its clinical application value is higher.
引文
[1]宋志平,曲良超,刘志毅.HC可视喉镜在院内急救气管插管的应用[J].江西医药,2014,49(9):907-909.
[2]陈军民,王平,胡晓萍.比较HC可视喉镜与直接喉镜在急诊气管插管患者中的应用效果[J].浙江创伤外科,2015,20(6):1182-1184.
[3]何伟,李建桥,原庆会,等.HC可视喉镜联合纤维光导支气管镜引导用于老年患者全身麻醉气管插管的临床研究[J].中国医学装备,2016,13(8):63-66.
[4]潘雪莲,顾俊峰,罗超.HC可视喉镜在老年患者气管内插管全麻中的应用[J].湖北医药学院学报,2015,34(3):300-302.
[5]梁俊雄,黄锦联,张伟良,等.HC可视喉镜在院外急救困难气道气管插管中的临床应用研究[J].现代中西医结合杂志,2017,26(16):1802-1804.
[6]贺志勇.HC可视喉镜联合纤维支气管镜引导气管插管在预测为严重困难气道中的效果评价[J].中国实用医药,2015,10(8):113-114.
[7] Plazikowski E,Greif R,Marschall J,et al.Emergency AirwayManagement in a Simulation of Highly Contagious IsolatedPatients:Both Isolation Strategy and Device Type Matter[J].InfectControl Hosp Epidemiol,2018,39(2):145-151.
[8]盛鹰,程英平,王树云,等.HC可视喉镜在急诊抢救室紧急气管插管中应用的回顾性分析[J].浙江临床医学,2018,20(2):344-346.
[9] Das B,Samanta A,Mitra S,et al.Comparative evaluation ofAirtraq?optical Laryngoscope and Miller’s blade in paediatricpatients undergoing elective surgery requiring tracheal intubation:A randomized,controlled trial[J].Indian J Anaesth,2017,61(4):326-331.
[10]瞿慧毅.HC可视喉镜在院前紧急气管插管患者中的应用[J].中国伤残医学,2014,22(14):113.
[11]王万灵,王灵,王振华,等.HC可视喉镜、直接喉镜在气管插管中的应用效果比较[J].山东医药,2015,55(11):39-40.
[12]潘龙飞,余蕾,裴红红,等.HC可视喉镜在急诊低年资住院医师紧急气管插管操作中的应用[J].中华急诊医学杂志,2016,25(7):910-914.
[13]潘龙飞,冯辉,余蕾,等.HC可视喉镜在急诊困难气道气管插管时的应用[J].陕西医学杂志,2015,44(10):1378-1380.
[14]周挺,朱春影,李晋岗,等.HC可视喉镜结合BURP手法在急诊科快速气管插管中的效果分析[J].临床医学研究与实践,2018,3(2):72-73.
[15]张家明,徐进宇,黄国荣,等.HC可视喉镜在重症颅脑外伤伴颅底骨折患者紧急气管插管中的应用[J].局解手术学杂志,2017,26(6):442-445.
[16] Sara?o?lu A,Dal D,Bayg?n?,et al.Airtraq,LMA CTrachand Macintosh Laryngoscopes in Tracheal Intubation Training:ARandomized Comparative Manikin Study[J].Turk J AnaesthesiolReanim,2016,44(2):76-80.
[17] Gaszyński T,Jakubiak J.Muscle activity during endotrachealintubation using 4 laryngoscopes(Macintosh laryngoscope,Intubrite,TruView Evo2 and King Vision)-A comparativestudy[J].Med Pr,2016,67(2):155-162.
[18]潘建红,楼静芝,周海燕.HC可视喉镜在双腔支气管插管中的实用性探讨[J].浙江医学,2014,36(9):796-798.
[19]赵国胜,安洁.HC可视喉镜联合纤维光导支气管镜引导全身麻醉气管插管的临床效果观察[J].中国内镜杂志,2014,20(7):772-774.
[20]樊媛,潘龙飞,孙师元,等.HC可视喉镜紧急气管插管对急诊科休克伴呼吸衰竭患者血流动力学的影响[J].陕西医学杂志,2017,46(2):234-235,245.
[2]陈军民,王平,胡晓萍.比较HC可视喉镜与直接喉镜在急诊气管插管患者中的应用效果[J].浙江创伤外科,2015,20(6):1182-1184.
[3]何伟,李建桥,原庆会,等.HC可视喉镜联合纤维光导支气管镜引导用于老年患者全身麻醉气管插管的临床研究[J].中国医学装备,2016,13(8):63-66.
[4]潘雪莲,顾俊峰,罗超.HC可视喉镜在老年患者气管内插管全麻中的应用[J].湖北医药学院学报,2015,34(3):300-302.
[5]梁俊雄,黄锦联,张伟良,等.HC可视喉镜在院外急救困难气道气管插管中的临床应用研究[J].现代中西医结合杂志,2017,26(16):1802-1804.
[6]贺志勇.HC可视喉镜联合纤维支气管镜引导气管插管在预测为严重困难气道中的效果评价[J].中国实用医药,2015,10(8):113-114.
[7] Plazikowski E,Greif R,Marschall J,et al.Emergency AirwayManagement in a Simulation of Highly Contagious IsolatedPatients:Both Isolation Strategy and Device Type Matter[J].InfectControl Hosp Epidemiol,2018,39(2):145-151.
[8]盛鹰,程英平,王树云,等.HC可视喉镜在急诊抢救室紧急气管插管中应用的回顾性分析[J].浙江临床医学,2018,20(2):344-346.
[9] Das B,Samanta A,Mitra S,et al.Comparative evaluation ofAirtraq?optical Laryngoscope and Miller’s blade in paediatricpatients undergoing elective surgery requiring tracheal intubation:A randomized,controlled trial[J].Indian J Anaesth,2017,61(4):326-331.
[10]瞿慧毅.HC可视喉镜在院前紧急气管插管患者中的应用[J].中国伤残医学,2014,22(14):113.
[11]王万灵,王灵,王振华,等.HC可视喉镜、直接喉镜在气管插管中的应用效果比较[J].山东医药,2015,55(11):39-40.
[12]潘龙飞,余蕾,裴红红,等.HC可视喉镜在急诊低年资住院医师紧急气管插管操作中的应用[J].中华急诊医学杂志,2016,25(7):910-914.
[13]潘龙飞,冯辉,余蕾,等.HC可视喉镜在急诊困难气道气管插管时的应用[J].陕西医学杂志,2015,44(10):1378-1380.
[14]周挺,朱春影,李晋岗,等.HC可视喉镜结合BURP手法在急诊科快速气管插管中的效果分析[J].临床医学研究与实践,2018,3(2):72-73.
[15]张家明,徐进宇,黄国荣,等.HC可视喉镜在重症颅脑外伤伴颅底骨折患者紧急气管插管中的应用[J].局解手术学杂志,2017,26(6):442-445.
[16] Sara?o?lu A,Dal D,Bayg?n?,et al.Airtraq,LMA CTrachand Macintosh Laryngoscopes in Tracheal Intubation Training:ARandomized Comparative Manikin Study[J].Turk J AnaesthesiolReanim,2016,44(2):76-80.
[17] Gaszyński T,Jakubiak J.Muscle activity during endotrachealintubation using 4 laryngoscopes(Macintosh laryngoscope,Intubrite,TruView Evo2 and King Vision)-A comparativestudy[J].Med Pr,2016,67(2):155-162.
[18]潘建红,楼静芝,周海燕.HC可视喉镜在双腔支气管插管中的实用性探讨[J].浙江医学,2014,36(9):796-798.
[19]赵国胜,安洁.HC可视喉镜联合纤维光导支气管镜引导全身麻醉气管插管的临床效果观察[J].中国内镜杂志,2014,20(7):772-774.
[20]樊媛,潘龙飞,孙师元,等.HC可视喉镜紧急气管插管对急诊科休克伴呼吸衰竭患者血流动力学的影响[J].陕西医学杂志,2017,46(2):234-235,245.
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