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用于急诊患者困难插管的GlideScope视频喉镜:一项半随机对照试验。

GlideScope Video Laryngoscope for Difficult Intubation in Emergency Patients: a Quasi-Randomized Controlled Trial.

作者信息

Ahmadi Koorosh, Ebrahimi Mohsen, Hashemian Amir Masoud, Sarshar Saeed, Rahimi-Movaghar Vafa

机构信息

Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Acta Med Iran. 2015 Dec;53(12):738-42.

Abstract

Macintosh direct laryngoscope has been the most widely used device for tracheal intubation. GlideScope video laryngoscope (GVL) has been recently introduced as an alternative device for performing intubation; however, its validity in emergency settings has not been thoroughly evaluated. The aim of this study was to compare Macintosh direct laryngoscope versus GVL for emergency endotracheal intubation. This quasi-randomized clinical trial was performed on 97 patients referred to Imam Reza Hospital whom all needed emergency intubation in 2011. Patients were divided into two groups of the easy airway and difficult airway; intubation was performed for patients with direct laryngoscopy or GVL. Then, the patients were evaluated in terms of demographic characteristics, successful intubation rate and intubation time. Data was analyzed by SPSS software 16. There was no significant difference in demographic characteristics of the patients in both easy airway and difficult airway groups who intubated with direct laryngoscopy and GVL methods (P>0.05). In difficult airway group, a significant difference was found in successful intubation at the first attempt (60.9% vs. 87.5%; P=0.036), overall intubation time (32.7 ± 14.58 vs. 22.5±7.88; P<0.001) and first attempt intubation time (28.43 ± 12.51 vs. 21.48±7.8; P=0.001) between direct laryngoscopy and GVL. These variables were not significantly different between two methods in easy airway group. According to the results, GVL can be a useful alternative to direct laryngoscopy in emergency situations and especially in cases with a difficult airway.

摘要

麦金托什直接喉镜一直是气管插管最广泛使用的器械。GlideScope视频喉镜(GVL)最近作为一种替代器械被引入用于插管操作;然而,其在紧急情况下的有效性尚未得到充分评估。本研究的目的是比较麦金托什直接喉镜与GVL用于紧急气管插管的情况。这项半随机临床试验于2011年对97名转诊至伊玛目礼萨医院且均需要紧急插管的患者进行。患者被分为气道容易组和气道困难组;分别使用直接喉镜或GVL为患者进行插管。然后,对患者的人口统计学特征、插管成功率和插管时间进行评估。数据采用SPSS 16软件进行分析。采用直接喉镜和GVL方法插管的气道容易组和气道困难组患者的人口统计学特征无显著差异(P>0.05)。在气道困难组中,直接喉镜与GVL在首次尝试插管成功率(60.9%对87.5%;P=0.036)、总插管时间(32.7±14.58对22.5±7.88;P<0.001)和首次尝试插管时间(28.43±12.51对21.48±7.8;P=0.001)方面存在显著差异。在气道容易组中,两种方法在这些变量上无显著差异。根据结果,在紧急情况下,尤其是在气道困难的病例中,GVL可作为直接喉镜的一种有用替代方法。

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