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梨状窝定位辅助盲插气管内插管:与喉镜直视下插管的比较

Pyriform sinus localization-assisted blind intubation: comparison with laryngoscopic intubation.

作者信息

Zhong Qin-wen, Ye Jun-ming, Xu Shi-yuan

机构信息

First Affiliated Hospital, Gannan Medical University, Ganzhou, China (mainland).

Zhujiang Hospital, Southern Medical University, Guangzhou, China (mainland).

出版信息

Med Sci Monit. 2014 Sep 25;20:1720-7. doi: 10.12659/MSM.892195.

Abstract

BACKGROUND

Conventional endotracheal intubation requires laryngoscopy for a direct view of the glottis. However, laryngoscopy is associated with many potential complications. The aim of the present study was to compare the efficacy and safety of pyriform sinus localization-assisted blind orotracheal intubation with those of conventional laryngoscopic orotracheal intubation.

MATERIAL AND METHODS

A randomized, patient-blind, prospective study of 300 patients who underwent various operations was performed. One hundred patients were assigned to the laryngoscopic intubation group (laryngoscopy group), and 200 patients were assigned to the blind intubation group (blind group).

RESULTS

The total intubation success rate in the blind group was similar to that in the laryngoscopy group (100% vs. 99%, respectively; p=0.33). Oxygen saturation by pulse oximetry in both groups was maintained at >98%. The intubation time was significantly shorter in the blind group than in the laryngoscopy group (9.7±3.4 s vs. 23.0±5.8 s, respectively; p<0.001). Postoperative complication rates were significantly lower in the blind group than in the laryngoscopy group. Recovery time from these symptoms was significantly shorter in the blind group than in the laryngoscopy group (p=0.004).

CONCLUSIONS

Pyriform sinus localization-assisted blind orotracheal intubation was shown to be more effective than conventional laryngoscopic orotracheal intubation in terms of success rate, intubation time, and postoperative complication rate. Moreover, it is less affected by common risk factors; thus, this method may be more beneficial in patients with difficult airways.

摘要

背景

传统气管插管需要借助喉镜直接观察声门。然而,喉镜检查存在许多潜在并发症。本研究的目的是比较梨状窦定位辅助盲探经口气管插管与传统喉镜经口气管插管的有效性和安全性。

材料与方法

对300例接受各种手术的患者进行了一项随机、患者盲法、前瞻性研究。100例患者被分配至喉镜插管组(喉镜组),200例患者被分配至盲探插管组(盲探组)。

结果

盲探组的总插管成功率与喉镜组相似(分别为100%和99%;p = 0.33)。两组患者的脉搏血氧饱和度均维持在>98%。盲探组的插管时间显著短于喉镜组(分别为9.7±3.4秒和23.0±5.8秒;p<0.001)。盲探组的术后并发症发生率显著低于喉镜组。盲探组这些症状的恢复时间显著短于喉镜组(p = 0.004)。

结论

在成功率、插管时间和术后并发症发生率方面,梨状窦定位辅助盲探经口气管插管比传统喉镜经口气管插管更有效。此外,它受常见危险因素的影响较小;因此,这种方法可能对气道困难的患者更有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e071/4186215/b2b11b809792/medscimonit-20-1720-g001.jpg

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