DISCOPO内镜与McCoy喉镜在困难气道 清醒气管插管中的应用比较*

Comparison of DISCOPO endoscopy and McCoy laryngoscope during awake intubation for patients with difficult airway*

摘要:

摘要：目的 观察DISCOPO内镜与McCoy喉镜在困难气道清醒气管插管中的临床应用效果。方法 将符合困难气道诊断标准的择期全麻下手术患者60例随机分为DISCOPO内镜组（D组）和McCoy喉镜组（M组），每组各30例，两组患者在表面麻醉与右美托咪定镇静的基础上，M组运用McCoy喉镜进行气管插管，D组使用DISCOPO内镜进行气管插管，记录两组患者气管插管所用时间、一次性气管插管成功率，声门暴露分级、插管并发症发生情况和围插管期血流动力学[血压（BP）和心率（HR）]变化。结果 D组气管插管时间短于M组（P <0.05），一次性插管成功率及声门暴露良好率明显高于M组（P <0.05），并发症发生率明显低于M组（P <0.05），D组T2和T3时间点BP和HR明显低于M组（P <0.05）。结论 DISCOPO内镜用于困难气道清醒插管用时短，成功率高，并发症少，值得临床推广应用。

Abstract:

Abstract: Objective To compare DISCOPO endoscopy and McCoy laryngoscope in awake intubation in patients with difficult airway. Methods 60 patients with difficult airway who would have elective surgery were randomly divided into DISCOPO endoscopy group (Group D, n = 30) and McCoy group (Group M, n = 30). The patients in Group M got tracheal intubation by McCoy laryngoscope while the patients in Group D got tracheal intubation by DISCOPO after the topical tracheal anesthesia and Dexmedetomidine sedation. The time of Tracheal intubation, the first-time success rate of intubation, the Grading of glottis exposure, the adverse reactions related to intubation, blood pressure and heart rate during intubation period were observed and monitored. Results The time of tracheal intubation in Group D was obviously shorter than that in Group M (P < 0.05), the first-time success rate of intubation and the rate of low grading about glottal exposure in Group D were significantly higher than that in group M (P < 0.05). The incidence of complications in group D was significantly lower than that in group M (P < 0.01). The blood pressure and heart rate in group D were significantly lower than that in group M at T2 and T3 points (P < 0.01). Conclusions DISCOPO endoscope provided less intubation time, higher success rate and less complication in awake intubation in patients with difficult airway compared with McCoy laryngoscope.