维迪欧视频喉镜和GlideScope视频喉镜在双腔支气管插管中的应用比较

Comparison of GlideScope and Vdoscope laryngoscope in double-lumen endobronchial intubation

关键词:  维迪欧视频喉镜  GlideScope视频喉镜  双腔支气管导管  插管时间  成功率

Key words:  Vdoscope laryngoscope  Glide Scope laryngoscope  double-lumen endobronchial tube  intubation time  success rate

摘要:

目的 评估维迪欧视频喉镜在择期肺叶切除术患者行全身麻醉诱导双腔支气管插管中的实用性和安全性。方法 择期拟行经口左双腔支气管插管全身麻醉手术患者400例，美国麻醉医师协会（ASA）分级Ⅰ～Ⅲ级，年龄18～70岁。采用随机数表法将患者纳入A、B两组，A组代表GlideScope视频喉镜组，B组代表维迪欧视频喉镜组。记录两组插管时间、一次插管成功率、插管前后血流动力学波动、术后咽喉疼痛及声嘶等情况。结果 A，B两组的插管时间差异无统计学意义，第1次插管成功率差异也无统计学意义；插管前后A，B两组的平均动脉压及心率的波动差异无统计学意义；拔管后1h及拔管后1d，A，B两组的术后声嘶的差异无统计学意义（均P≥0.05）。但A组在拔管1d后轻度咽喉疼痛的发病率显著高于B组（14% vs 7.5%，P＜0.05）。结论 从插管时间、成功率，插管所导致的心血管反应，术后咽喉疼痛及声嘶等方面的结果来看，维迪欧视频喉镜可以安全应用于辅助DLT插管。

Abstract:

Objective To compare Vdoscope and GlideScope assisted Double-lumen endobronchial(DLT) intubation in general anesthesia for elective lung lobectomy. Methods Four hundred patients undergoing elective pulmonary lobectomy were randomly divided into two groups for DLT intubation: in group A GlideScope laryngoscope was used to assist DLT intubation, in group B Vdoscope laryngoscope was used. The endobronchial intubation time and the success rate for the first try were recorded, the cardiovascular fluctuations and postoperative sore throat and hoarseness were evaluated. Results There were no significant differences in intubation time and success rate between the two groups. And there were no significant differences in mean arterial pressure, the heart rate fluctuations and postoperative hoarseness between the two groups, and neither were the significantly different between the 2 groups. But the mild postoperative sore throat on the second day after extubation was significantly worse in group A than that in group B(14% vs 7.5%). Conclusion Vdoscope is applicable and safe in DLT intubation; the intubation time, success rate, cardiovascular fluctuations and postoperative hoarseness are comparable to those of GlideScope, and the incidence of postoperative sore throat is even lower.