摘要
目的比较可视喉罩与纤维支气管镜引导气管插管在颈椎手术中的应用效果及血流动力学变化。方法选择80例拟行颈椎手术患者,按随机数字表法分为研究组和对照组,各40例,分别采用可视喉罩和纤维支气管镜引导气管插管麻醉。比较两组应用效果及患者血流动力学变化。结果研究组气管导管置入时间、抬起下颌例数均明显少于对照组(P<0.001),一次插管成功率高于对照组(P<0.05);插管前(T1)、插管后30 s(T2)及插管后5 min(T3)两组患者心率(HR)、舒张压(DBP)、收缩压(SBP)均呈现先升高后降低的趋势,且研究组T2时HR、DBP及SBP均低于对照组(P<0.05)。研究组并发症发生率明显低于对照组(P<0.001)。结论颈椎手术中采用可视喉罩引导气管插管较纤维支气管镜具有更优的临床应用效果,首次插管成功率更高,能够缩短气管插管时间,维持血流动力学稳定,有效降低并发症风险。
Objective To compare the efficacy and hemodynamic changes between visual laryngeal mask-guided and fiberoptic bronchoscope-guided tracheal intubation in cervical spine surgery.Methods Eighty patients scheduled for cervical spine surgery were randomly divided into the study group and the control group(n=40 each).The study group received visual laryngeal mask-guided tracheal intubation,while the control group underwent fiberoptic bronchoscope-guided tracheal intubation.The efficacy and hemodynamic changes were compared between the two groups.Results Compared to the control group,the study group demonstrated significantly shorter the intubation time(P<0.001),fewer cases requiring jaw lift(P<0.001),and higher first-attempt success rate(P<0.05).Both groups showed an initial increase followed by decrease in heart rate(HR),diastolic blood pressure(DBP),and systolic blood pressure(SBP)at pre-intubation(T1),30 seconds post-intubation(T2),and 5 minutes post-intubation(T3).Importantly,the study group showed significantly lower HR,DBP,and SBP at T2 compared to the control group(P<0.05).Moreover,the complication rate was significantly lower in the study group(P<0.05).Conclusion Visual laryngeal mask-guided tracheal intubation demonstrates superior clinical efficacy over fiberoptic bronchoscope-guided intu-bation in cervical spine surgery,providing a higher first-pass success rate,reduced intubation time,improved hemodynamic stability,and lower rates of intubation-related complications.
作者
文也新
陈超
陈剑钊
詹银周
郭春明
陈超
WEN Yexin;CHEN Chao;CHEN Jianzhao;ZHAN Yinzhou;GUO Chunming;CHEN Chao(Department of Anesthesiology,Shantou Central Hospital,Shantou 515000,Guangdong,China;Depart-ment of Spinal Surgery,Shantou Central Hospital,Shantou 515000,Guangdong,China)
出处
《中国现代手术学杂志》
2025年第3期254-258,共5页
Chinese Journal of Modern Operative Surgery
基金
汕头市科技计划医疗卫生类别项目(230510106497041)。
关键词
气管插管
可视喉罩
纤维支气管镜
血流动力学
颈椎手术
tracheal intubation
visual laryngeal mask
fiberoptic bronchoscope
hemodynamics
cervical spine surgery
