双镜联合用于阻塞性睡眠呼吸暂停综合征患者经鼻气管插管的观察*

Clinical application of Fiberoptic bronchoscope combined with Glidescope videolaryngoscope for nasotracheal intubation in patients with obstructive sleep apnea syndrome*

摘要:

摘要：目的 观察纤维支气管镜（FOB）联合Glidescope视频喉镜（GVL）用于阻塞性睡眠呼吸暂停综合征（OSAS）患者经鼻气管插管的效果。方法 拟行腭咽成型术的OSAS患者90例，随机分为M、G和F 3组，每组30例，M组使用普通喉镜、G组使用GVL、F组使用FOB联合GVL经鼻气管插管，记录麻醉开始前（T0）、气管插管即刻（T1）、插管后1?min（T2）和5?min（T3）的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）和气管插管时间，观察喉镜显露Cormack-Lehane（C-L）分级情况及一次插管成功率、按压喉外部和使用气管插管钳的发生率以及鼻腔出血和低氧血症的发生率。结果 C-L分级G和F组优于M组（P?<0.05），一次插管成功率M组低于G和F组（P?<0.05），需按压喉外部F组低于M和G组（P?<0.05），G组低于M组（P?<0.05），使用气管插管钳次数和鼻腔出血的发生率F组低于M和G组（P?<0.05）。结论 FOB联合GVL用于OSAS患者经鼻气管插管，可提高气管插管成功率，减少鼻腔出血。

Abstract:

Abstract: Objective To observe the effect of fiberoptic bronchoscope (FOB) combined with glidescope videolaryngoscope (GVL) for nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS). Methods 90 patients with OSAS scheduled to undergo palatal pharyngoplasty were randomly assigned to three groups (n?=?30): direct laryngoscope group (M group), GVL group (G group) and FOB with GVL group (F group). SBP, DBP, MAP and HR were recorded before induction of anesthesia (T0), during tracheal intubation (T1) and at 1 min (T2), 5 min (T3) after tracheal intubation was completed. The intubation time was also observed. Cormack-Lehane (C-L) classification, the success rate of intubation, the incidence of pressing laryngeal external and using tracheal intuabting forceps, the incidence of nasal bleeding and hypoxemia were determined. Results The C-L classification was better in G and F group than M group (P?