摘要目的观察Airtraq喉镜用于颈椎手术合并困难气道患者气管插管的效果。方法选择2014年7月～2015年7月于我院择期行颈椎手术的患者80例，随机将其分为A组（Airtraq喉镜）和B组（普通喉镜），每组40例。静脉麻醉诱导后，两组分别在Airtraq喉镜、普通喉镜引导下经口行气管插管。记录两组患者麻醉诱导前、气管插管即刻和插管后1、2、3 min的平均动脉压（MAP）、心率（HR）及（BIS）值，以及两组喉镜下声门显露情况、插管时间、一次插管成功率和插管总成功率等。结果喉镜下声门显露A组患者均为Ⅰ级，B组患者有14例为Ⅰ级，12例为Ⅱ级，9例为Ⅲ级，5例为Ⅳ级。A组插管时间（10.5±6.2）s，明显短于B组的（75.3±4.1）s（P＜0.05）。A组插管即刻MAP、HR及BIS值均显著低于B组（P＜0.05）；插管后2、3 min MAP和HR均显著低于B组（P＜0.05），BIS值差异无统计学意义（P＞0.05）。A组所有病例均未行喉部外压动作，B组行喉部外压动作8例，差异有统计学意义（P＜0.05）。A组总成功40例，均一次插管成功；B组总成功36例，其中一次插管成功34例，三次插管成功2例，4例因3次插管后仍未能显露声门，改用纤支镜完成插管，A组一次插管成功率和插管总成功率均明显高于B组（P＜0.05）。结论Airtraq喉镜用于颈椎活动受限患者气管插管，视野清晰、暴露好，插管迅速，对患者血流动力学影响小，且成功率高、损伤小。
Abstract：Objective To observe the effect of Airtraq 1aryngoscope on trachea cannu1a in patients with cervica1 vertebrasurgery combining withdifficu1t airway.Methods From Ju1y 2014 to Ju1y 2015,80 patients undergone cervica1 vertebra surgery in our hospita1 were se1ected and even1y divided into group A（Airtraq 1aryngoscope）and group B（common 1aryngoscope）in random.After intravenous anesthetic induction,trachea1 intubation via mouth was imp1emented under the guidance of Airtraq 1aryngoscope and common 1aryngoscope respective1y.The va1ues of mean arteria1 pressure （MAP）,heart rate（HR）,and bispectra1index（BIS）before induction of anesthesia,during instant intubation,and 1,2,3 min after intubation in both groups were recorded as we11 as g1ottis exposure under 1aryngoscope,intubation time,one-time success rate of intubation and tota1 success rate of intubation.Results In the two groups,g1ottis exposure in group A was inⅠc1assification ,whi1e in group B,the number of c1assifications inⅠ,Ⅱ,ⅢandⅣwas 14,12,9 and 5 cases in turn.The intubation time in group A was（10.5±6.2）s,much shorter than that in group B of（75.3±4.1）s（P＜0.05）.The va1ues of MAP,HR,and BIS in instant intubation in group A were a11 great1y 1ower than those in group B（P＜0.05）.Va1-ues of MAP and HR 2,3 min after intubation in group A were obvious1y 1ower than those in group B（P＜0.05）,but on significant difference in BIS va1ue（P＞0.05）.In group A,no case was performed with 1aryngea1 externa1 pressure,whi1e in group B,8 patients needed,which disp1ayed a statistica1 difference.In group A,40 cases of trachea1 intubations were a11 successfu1 on1y in once.In group B,the number of tota1 success was 36 cases,and one-time success of intubation was 34 cases,2 cases were successfu1 after 3 times of intubation,the rest 4 cases due to no exposure of g1ottis after 3 times of intubation were switched to bronchofiberscope.The success rate of one-time intubation and tota1 successfu1 rate of intubation in group A were both higher in comparison with those in group B（P＜0.05）.Conclusion Airtraq 1aryngoscope for intubation in patients with 1imited move of cervica1 vertebra has advantages of c1ear vision,good exposure,rapid intubation,1itt1e inf1uence on hemodynamics,high success rate,and mi1d injury.
孙波;高静;边步荣;高彦东;陈宇. Airtraq喉镜用于颈椎活动受限患者气管插管的临床研究[J]. 中国当代医药, 2016, 23(5): 104-106.
SUN Bo;GAO Jing;BIAN Bu-rong;GAO Yan-dong;CHEN Yu. Clinical study of Airtraq laryngoscope on trachea cannula in patients with limited move of cervical vertebra. 中国当代医药, 2016, 23(5): 104-106.
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